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