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CMS Pub. 100-04, ch. 19, § 80.4.1

A/B MAC (B) - Vaccines and Vaccine Administration -

activein force · 2026-08-25 – presentas-observed

Coverage Policy

(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)

Pneumococcal Pneumonia Vaccinations

The Medicare Part B program covers PPV and its administration when furnished in

compliance with any applicable State law by any provider of services or any entity or

individual with a supplier number. This includes revaccination of patients at highest risk

of pneumococcal infection. Typically, these vaccines are administered once in a lifetime

except for persons at highest risk. See Chapter 18 of Pub. 100-04, Medicare Claims

Processing Manual for more information on this benefit.

Hepatitis B Vaccine

The Medicare Part B program provides coverage of hepatitis B vaccine and its

administration, furnished to a Medicare beneficiary who is at high or intermediate risk of

contracting hepatitis B. See Chapter 18 of Pub. 100-04, Medicare Claims Processing

Manual for more information on this benefit.

Influenza Virus Vaccine

The Medicare Part B program covers influenza virus vaccine and its administration when

furnished in compliance with any applicable State law by any provider of services or any

entity or individual with a supplier number. Typically, these vaccines are administered

once a year in the fall or winter. Medicare does not require, for coverage purposes, that a

doctor of medicine or osteopathy order the vaccine. Therefore, the beneficiary may

receive the vaccine upon request without a physician’s order and without physician

supervision. See Chapter 18 of Pub. 100-04, Medicare Claims Processing Manual for

more information on this benefit.

History

(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
66a921bbeccbd273d8681a1627c4dafad8b321d4c9e13660578e2e532094eeb9
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