CMS Pub. 100-04, ch. 18, § 10.3.2.1

Vaccination Services by HHAs

(Rev. 11355; Issued:04-14-22; Effective:05-16-22; Implementation:05-16-22)

The following billing instructions apply to HHAs that roster bill for influenza virus and

pneumococcal vaccines.

• When an HHA provides the influenza virus vaccine or the pneumococcal vaccine in a mass

immunization setting, it does not have the option to pick and choose whom to bill for this

service. If it is using employees from the certified portion, and as a result will be reflecting

these costs on the cost report, it must bill the A/B MAC (HHH) on the Form CMS-1450.

• If the HHA is using employees from the noncertified portion of the agency (employees of

another entity that are not certified as part of the HHA), and as a result, will not be

reflecting these costs on the cost report, it must obtain a provider number and bill their A/B

MAC (B) on the Form CMS-1500.

• If employees from both certified and noncertified portions of the HHA furnish the vaccines

at a single mass immunization site, they must prepare two separate rosters, e.g., one for

employees of the certified portion to be submitted to the A/B MAC (HHH) and one roster

for employees of the noncertified portion to be submitted to the A/B MAC (B).