Pharmacy Question for the Week of June 11, 2018

Pharmacy Compliance Question of the Week

Question:

As a follow-up to last week’s QA about hepatitis B vaccine payment, what is the Medicare policy for hospital outpatient departments administering for home dialysis patients?

Answer:

According to the Medicare Claims Processing Manual, when the vaccine is administered in a hospital outpatient department for home-dialysis patients or for patients with chronic renal failure (but not yet on dialysis), payment is on a reasonable cost basis. Outpatient hospital vaccines for nondialysis purposes are paid under hospital outpatient prospective payment system (OPPS) rules.

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