New CPT Codes Administration and H1N1 vaccine
* There are new codes for the administration/vaccine
G9141 Influenza A (H1N1) immunization administration (includes the physician counseling of the patient/family). Report one unit/beneficiary for each administration. Copay and deductible will not apply to code G9141.
G9142 is for the vaccine itself: Influenza A (H1N1) vaccine, any route of administration. Remember, if you receive the serum free, don’t bill/report this code.
The vaccine is free – do not bill Medicare for vaccine if your clinic didn’t pay for it
* You can bill for vaccine administration. Payment for administration of the H1N1 vaccine is the same as the payment established for HCPCS codes G0008 and G0009, the codes used for reporting the administration of the influenza or pneumococcal vaccine.
CPT® codes
90470 — H1N1 immunization administration (intramuscular, intranasal), including counseling when performed
90663 — Influenza virus vaccine, pandemic formulation, H1N1
To see details on H1N1 administration, fact shhets for the public and more, go to the CMS website:
http://www.cms.hhs.gov/Emergency/10_PandemicFlu.asp#TopOfPage
There are numerous downloads there including
H1N1 – Medicare FFS – Emergency Qs & As (10-09-09) [PDF 322KB]
Medicare’s Coverage of the H1N1 Flu Vaccine [PDF, 70 KB]
H1N1 Fact Sheet-Medicare FFS Provider Billing (9-25-09) [PDF, 70KB]
EMTALA Fact Sheet [PDF, 166 KB]
2009 H1N1 Guidance for States [PDF, 128 KB]
