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Last Modified: 11/14/2019 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 only applies to influenza and pneumococcal immunizations.

Roster billing for Part A providers

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

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) on and AFTER October 1, 2015: Influenza virus vaccine: CMS-1500 (02/12) example with ICD-10 codes pdf file

Additional resources for mass immunizers

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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.