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Reminder: ZIP Code Needed on Claims with Flu Vaccine Codes

Medicare Part B requires the location where the service(s) are rendered to be included on the claim for every service payable under the MPFS.

In Box 32 on the CMS-1500 claim form, Loop 2310C on the electronic equivalent, you must enter the complete address and the ZIP code may be entered. Medicare reimbursements are made based on the ZIP code reported.

We recently determined in our two Massachusetts localities, the reimbursement for flu vaccine administration HCPCS code G0008 (Administration of influenza virus vaccine), HCPCS code G0009 (Administration of pneumococcal vaccine) and G0010 (Administration of hepatitis B vaccine) will be updated to pay based on the facility locality reported.

Effective 7/15/2019, the Medicare allowed charge based on the ZIP code locality rates for 2019 are:

  • Locality 99 = $17.78
  • Locality 01 = $19.03

Locality/Area and County Information

Locality/Area State Counties
1 MA Middlesex, Norfolk and Suffolk
99 MA All other counties

 

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Posted 6/10/2019