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September 28, 2021

Flu & Pneumococcal Vaccines: Expanded SNF Enforcement Discretion for Certain Pharmacy Billing

Effective September 20, 2021, CMS exercised enforcement discretion for Skilled Nursing Facility (SNF) consolidated billing provisions related to flu and pneumococcal vaccines. This allows Medicare-enrolled immunizers, including pharmacies, to bill directly and get direct reimbursement from the Medicare program (including vaccine administration and product), whether these vaccines are administered at the same time (co-administered) with a COVID-19 vaccine or at different times. Visit the SNF: Enforcement Discretion Relating to Certain Pharmacy BillingExternal website webpage.

Vaccinations for respiratory illnesses reduce the impact and resulting burdens on the health care system during the COVID-19 PHE. The CDC recommends that patients in post-acute care facilities get the flu vaccine during the COVID-19 pandemicExternal website.

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