Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid www.mass.gov/masshealth MassHealth Home Health Agency Bulletin 47 March 2012 TO: Home Health Agencies Participating in MassHealth FROM: Julian J. Harris, M.D., Medicaid Director RE: Coverage of Seasonal Influenza Vaccinations Background This bulletin contains MassHealth payment and coverage policies and billing instructions for the seasonal influenza vaccine administered by home health agencies to MassHealth members in the absence of a skilled nursing visit or office visit. Eligible Members Eligible individuals are MassHealth members who are eligible to receive home health services and who have not received the seasonal flu vaccine as part of a home visit or office visit. Eligible Providers Effective November 4, 2011, MassHealth pays home health agencies to administer the seasonal influenza vaccine, as described in this bulletin. Payment and Billing for MassHealth will make a separate payment to home health agencies to Seasonal Influenza administer the seasonal flu vaccine to eligible MassHealth members in Administration the absence of a skilled nursing visit or office visit. Home health agencies must submit a separate claim for each member vaccinated, and bill as follows. Service Description Service Code Diagnosis Code Administration Fee Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); one vaccine (single or combination vaccine/toxoid) 90471 V04.81 $13.76 Immunization administration by intranasal or oral route; one vaccine (single or combination vaccine/ toxoid) 90473 V04.81 $9.06 Questions If you have any questions about the information in this bulletin, please contact MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974. MassHealth Home Health Agency Bulletin 47 January 2012 Page 2