Question:
As a follow-up to last week’s QA about hepatitis B vaccine payment, what is the Medicare policy for hospital outpatient departments administering for home dialysis patients?
Answer:
According to the Medicare Claims Processing Manual, when the vaccine is administered in a hospital outpatient department for home-dialysis patients or for patients with chronic renal failure (but not yet on dialysis), payment is on a reasonable cost basis. Outpatient hospital vaccines for nondialysis purposes are paid under hospital outpatient prospective payment system (OPPS) rules.
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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