Avoid denials by submitting Medicare Advantage COVID-19 vaccine claims to the right place – California Medical Association

December 15, 2021

Physicians are reminded that the Centers for Medicare and Medicaid Services (CMS) will change the way physicians bill and are paid for COVID-19 vaccine administration services for Medicare Advantage enrollees effective January 1, 2022. For Medicare Advantage patients vaccinatedon or afterJanuary 1, 2022, COVID-19vaccine administration claims should be submittedto the patients Medicare Advantage plan.Fee-for-service (FFS) Medicare will no longer paythese claims.

Currently and for services provided through the end of 2021, Medicare Advantage claims must be submitted directly to Noridian, the Medicare FFS Administrative Contractor in order to be paid.

The California Medical Association (CMA) has published several resources includingCMAs COVID-19 Vaccine Reimbursement Quick GuideandCOVID-19 Vaccine Toolkit for Physician Practicesto provide answers to frequently asked physician questions about the COVID-19 vaccine rollout and billing guidance on administration of the vaccine. Both resources are updated frequently with the latest information regarding COVID-19 Vaccines.

If your practice has questions regarding COVID-19 vaccine billing or is experiencing reimbursement challenges, please contact CMA atEconomicServices@cmadocs.orgor (888) 401-5911.

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Avoid denials by submitting Medicare Advantage COVID-19 vaccine claims to the right place - California Medical Association