Vaccines

40.11 - Vaccines (Rev. 111, Issued: 09-25-09; Effective Date: 07-07-08; Implementation Date: 10-26- 09) A CORF may provide pneumococcal pneumonia, influenza virus, and hepatitis B vaccines to its patients. While not included as a service under the CORF benefit, Medicare will make payment to the CORF for certain vaccines and their administration provided to CORF patients (CY 2008 PFS Rule 72 FR 66293). The following three vaccinations are covered in a CORF if a physician who is a doctor of medicine or osteopathy orders it for a CORF patient: • Pneumococcal pneumonia vaccine and its administration; • Hepatitis B vaccine and its administration furnished to a beneficiary who is at high or intermediate risk of contracting hepatitis B; and • Influenza virus vaccine and its administration Payment for covered pneumococcal pneumonia, influenza virus, and hepatitis B vaccines provided in the CORF setting is based on 95 percent of the average wholesale price. The CORF registered nurse provides administration of any of these vaccines using HCPCS codes G0008, G0009 or G0010 with payment based on CPT code 90471.