Are You Using the Correct Influenza Vaccine HCPCS Code?

Home health and hospice providers should verify with their clinical and billing staff that they are using the correct influenza vaccine HCPCS code when submitting claims for the administration of the influenza virus vaccine. The Medicare Administrative Contractors (MACs) have begun notifying providers of incorrect usage since they have received claims with hospital-specific codes.

  • Home Health and Hospice providers (PPS) should utilize code G0008 on claim submission for Influenza Virus vaccines.
  • Hospitals providers (OPPS) utilize code 90471 when submitting claims for Influenza Virus vaccines.

If you have submitted HCPCS 90471 for the administration of the influenza flu vaccine on home health or hospice claims, you will likely need to submit an adjustment to change the HCPCS code to G0008.

Click here to view a notice from CGS regarding this update.

 

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