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2010 – 2011 Flu Clinics. August 26, 2010. Vaccine Administration. Codes 90465 Under age 8 injection 90467 Under age 8 intranasal 90471 Over age 8 injection 90473 Over age 8 intranasal Reimbursement Pays according to fee schedule (no longer capped at $8.00). Influenza Vaccine. Codes

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vaccine administration
Vaccine Administration

Codes

  • 90465 Under age 8 injection
  • 90467 Under age 8 intranasal
  • 90471 Over age 8 injection
  • 90473 Over age 8 intranasal

Reimbursement

  • Pays according to fee schedule (no longer capped at $8.00)
influenza vaccine
Influenza Vaccine

Codes

  • 90655 Preservative free, under age 3
  • 90656 Under age 3
  • 90657 Preservative free, over age 3
  • 90658 Over age 3
  • 90660 Intranasal, all ages

Reimbursement

  • State Supplied $0.50
  • Non-State Supplied AWP (Average Wholesale Price)
pneumococcal vaccine
Pneumococcal Vaccine

Codes

  • 90732 - Adult or Immunosuppressed over age 2 for subcutaneous or intramuscular use
  • 90669 - Conjugate vaccine under age 5 for intramuscular use

Reimbursement

  • State Supplied $0.50
  • Non-State Supplied AWP (Average Wholesale Price)
physician billing information
Physician Billing Information

Physician Offices

  • Use appropriate claim form – 1500 or electronic submission. (No roster billing)
  • Bill administration code for all Influenza vaccines, State supplied and non-State supplied.
  • Bill the base CPT code for the State supplied vaccine.
  • No modifier required.
flu clinic amendments
Flu Clinic Amendments
  • Flu Clinics (Mass Immunizers)
  • Public Clinics should be listed on the State of RI website.
  • No longer able to support roster billing
  • Bill on CMS-1500 or electronic version thereof
  • Will contact each provider with billing ID number and revised contracts
  • Administration reimbursement is capped at $15.00
contacts
Contacts

Network Account Managers:

  • Janine Forrest (401)-732-7296 –Bristol Count,MA
  • Tom Morrisroe (401)732-7410 – Burrillsville, Central Falls, Cranston, Cumberland, Foster, Glocester Greenville, Harmony, Johnston, Lincoln, N Providence, N Smithfield, Scituate, Smithfield, Woonsocket AND Mass Immunizers
  • Wayne Marshall (401) 732-7562 – Barrington, Bristol, Charlestown, Coventry, East Greenwich, E Providence, Exeter, Hope Valley, Hopkinton, Jamestown, Kingston, Little Compton, Middletown, Narragansett, New Shoreham, Newport, N. Kingstown, Pawtucket, Portsmouth, Richmond, Riverside, Rumford, S. Kingstown, Tiverton, Wakefield , Warren , Warwick, W. Greenwich W Warwick and Westerly

Provider Advocates:

  • Shannan Medeiros (401) 732-7115
  • Nettierose Cooley (401) 732-7456