Last Modified: 9/30/2015 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 in Public Health Centers (PHCs), shopping malls, grocery stores, senior citizen homes, or health fairs.
• Roster billing is not available for hepatitis B vaccinations.
• Roster billing does apply to influenza and pneumococcal immunizations.
Roster billing for Part A providers
Part A providers who use direct data entry (DDE) 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
Roster billing for Part B providers
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.
• For dates of service (DOS) prior to October 1, 2015: Influenza virus vaccine: CMS-1500 (02/12) example
• For DOS on and AFTER October 1, 2015: Influenza virus vaccine: CMS-1500 (02/12) example with ICD-10 codes
• For DOS prior to October 1, 2015: Pneumococcal pneumonia virus vaccine: CMS-1500 (02/12) example
• For DOS on and AFTER October 1, 2015: Pneumococcal pneumonia virus vaccine: CMS-1500 (02/12) example with ICD-10 codes
Additional resources for mass immunizers
Please use your browser's back button to return to the referring page.
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.