Important Clinical News

Recommended Adult Immunization Schedule

United States – 2016

The 2016 Adult Immunization Schedule was approved by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse-Midwives (ACNM). On February 2, 2016, the adult immunization schedule and a summary of changes from 2015 were published in the Annals of Internal Medicine, and the availability of the schedule was announced in the Morbidity and Mortality Weekly Report (MMWR) on February 4, 2016.

All clinically significant postvaccination reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Reporting forms and instructions on filing a VAERS report are available at www.vaers.hhs.gov or by telephone, 800-822-7967.

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Modifications to Medicare Part B Coverage of Pneumococcal Vaccinations

Provider Types Affected
This MLN Matters® Article is intended for physicians and other providers submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.

Provider Action Needed
Change Request (CR) 9051 provides an update to the Medicare pneumococcal vaccine coverage requirements, to align with new Advisory Committee on Immunization Practices (ACIP) recommendations. Make sure your billing staffs are aware of these updates.

Background
Medicare Part B covers certain vaccinations including pneumococcal vaccines. Specifically, Section 1861(s)(10)(A) of the Social Security Act, which is available at http://www.ssa.gov/OP_Home/ssact/title18/1861.htm, and regulations at 42 CFR 410.57 http://www.ecfr.gov/cgi-bin/text-

Download full PDF here.

 

Prevnar 13® Reimbursement Resource Sheet

Download the Prevnar 13® Reimbursement Resource Sheet here.