COVID-19 has seen cyclical dips and highs over the last year. After the January 2021 spike, COVID-19 cases in the U.S. peaked once again in September 2021. Thankfully, there has since been a decline in daily new cases reported. At the start of October, 57 percent of the population had been fully vaccinated, and 66 percent had received at least one dose. If you are vaccinating and testing for COVID-19 at your medical practice, then this COVID-19 medical billing update is for you.
CPT Codes for COVID-19 Medical Billing – Vaccines
The CDC has created COVID-19 medical billing codes specific to the vaccine manufacturer and the dose (first, second, third, and booster). Save this COVID-19 CPT Coding Guide from AMA to ascertain the correct CPT code depending on the type and dose of vaccine used.
CMS Guidelines on COVID-19 Vaccine Administration – Do’s and Don’ts
As a provider participating in the CDC COVID-19 Vaccination Program, you must ensure the following:
- Administer the COVID-19 vaccine without any balance billing to the vaccine recipient.
- Vaccinate the uninsured and those who are out-of-network recipients.
- Don’t bill for an office visit if the recipient has only come in for COVID-19 vaccination.
- Don’t stipulate that the recipient gets another medical service during the visit for COVID -19 vaccination.
You can submit a claim for reimbursement of COVID-19 vaccination through the recipient’s private insurance policy or under the Medicare, Medicaid, and HRSA COVID-19 Uninsured Program cover.
COVID-19 Vaccine Reporting
As a provider participating in the CDC COVID-19 Vaccination Program, you must report your COVID-19 vaccine inventory daily to Vaccines.gov. You may choose to display your location on Vaccines.gov, which will make it easier for the public to find information about your practice.
Medical Billing for COVID-19 Testing
CMS requires group and individual health plans to reimburse any COVID-19 testing conducted on or after March 18, 2020, without prior authorization or cost-sharing. It includes COVID-19 assessments done via telehealth and drive-through COVID-19 screening sites. Read this ACP update on the codes for COVID-19 testing.
Accurate COVID-19 medical billing is essential to ensure your practice is reimbursed for the vaccinations. As a medical billing service company with nearly a two-decade experience, PracticeForces is continuously working with U.S. medical practices to adapt to the healthcare industry’s dynamic landscape. We keep abreast of medical billing guidelines, report on current and emerging trends, and ensure that your practice billing is aligned with new regulations. If you seek a medical billing partner to boost your revenue collections and minimize denials, we are a phone call away.
