CMS recently issued guidance to States outlining existing Medicaid and CHIP authorities available to States for the administration of 2009 H1N1 vaccine. States should consult the guidance at the following link to address concerns that may arise...

CMS has established two new Healthcare Common Procedure Coding System (HCPCS) codes for 2009 H1N1 vaccine and vaccine administration: G9141- Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family), and...

For Medicare FFS beneficiaries, co-insurance and deductible requirements are not applied to influenza vaccine administration, including 2009 H1N1.

It is expected that persons aged 10 and over only require one dose of 2009 H1N1 vaccine. However, multiple administration fees will be covered for Medicare beneficiaries requiring multiple doses of H1N1 vaccine.

Yes, like the seasonal influenza vaccine, the 2009 H1N1 vaccine and its administration are covered under the Part B preventive services benefit for all Medicare beneficiaries with Part B coverage. For details on Medicare coverage and reimbursement for...

The currently established CPT code for 2009 H1N1 vaccine is s90663 (influenza virus vaccine, pandemic formulation, H1N1). This code may be reported in conjunction with the unique CPT code for H1N1 vaccine administration: l90470, H1N1 immunization...

This is up to each individual health plan, but the general expectation is that plans will reimburse for vaccine administration. According to America’s Health Insurance Plans, a national association representing nearly 1,300 companies that provide...

Any public or private provider who is designated as a 2009 H1N1 vaccinator by the public health authority in the jurisdiction where they practice can participate in the 2009 H1N1 vaccination program. In addition to physicians, private providers may...

Yes. While every effort is being made to ensure that cost is not a barrier for patient receipt of vaccine, providers may charge or bill for vaccine administration. Policies and procedures guiding this financial transaction are explained below.

No. 2009 H1N1 influenza vaccine and ancillary supplies (syringes, needles, sharps containers, and alcohol swabs) have been purchased by the federal government and provided free of charge to all providers participating in this voluntary vaccination...