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Institutional Providers: Additional Information

Guidance for institutional provider facility and bill types, RHC billing information, and FQHC billing information

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: August 21, 2020

RHC Billing Information

  • Don’t include influenza vaccine and administration on your claim
  • CMS pays for influenza vaccine and administration through the cost report

 

FQHC Billing Information

  • List charges for the vaccine and administration on a separate claim line from the billable visit
  • Don’t bill if you only provided vaccine administration
  • CMS pays for influenza vaccine and administration through the cost report

 

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.