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Last Modified: 6/9/2014 Location: FL, PR, USVI Business: Part A, Part B

Immunization roster billing

Roster billing may be used when immunizations are offered for large groups of beneficiaries, for instance at Public Health Centers (PHCs), shopping malls, grocery stores, senior citizen homes, and health fairs.
Roster billing is not available for hepatitis B vaccinations.
Roster billing does apply to influenza and pneumococcal immunizations.
To enable Medicare beneficiaries to participate in mass pneumococcal and influenza virus vaccination programs offered by PHCs and other individuals and entities that give vaccines to a group of beneficiaries, the simplified roster billing process was developed.
Visit First Coast’s forms page for information on immunization roster billing, including sample CMS-1500 forms and rosters.
Part A providers who use direct data entry (DDE) pdf file can submit roster bills by following the steps below:
To access the roster bill entry page, choose option '2' (claims/attachments) and then select option '87' (roster bill entry).
The page allows providers to enter pneumococcal and influenza vaccinations in a roster bill form. When completing the roster bill, providers should observe the following points:
Only one date of service per roster page
A maximum of 10 patients per roster page may be reported on a DDE roster page
Press F9 to transmit the claim
Click here for information on enrolling as a mass-immunizer.
Source: The Centers for Medicare & Medicaid Services (CMS) Internet-only manual (IOM) Pub. 100-04 Medicare Claims Processing Manual, chapter 18, section 10.3 external pdf file
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First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.