School-Based Clinics may begin to bill for the Administration of the H1N1 Vaccination
October 08, 2009
On October 1, 2009, the Department of Healthcare and Family Services (HFS) sent out a provider notification to all School Based Providers (please see attachment for provider notice). Within that notice, HFS indicated that School-Based Clinics may begin to bill for the Administration of the H1N1 Vaccination. The requirement for reimbursement is that the vaccination must be provided as part of a separate, IEP-related encounter.
An example of a billable encounter would be the following; if your School Nurse is seeing an IEP student to administer a regularly administered Medication, and also gives the IEP student the H1N1 vaccine that vaccination would then be billable.
An example of a non-billable vaccination would be the following; if the student is given the vaccination in a free clinic atmosphere where all students are given the vaccination, that vaccination would not be billable.
Please advise all nursing staff that GoClaim™ now has the option to submit for billable vaccinations administered during those sessions when another billable Nursing service has been provided. The new CPT code is G9141 Influenza A (H1N1) immunization administration, and is billed at a per event basis.
Please contact us at 800.260.2544 with any questions on this notification.