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Report HCPCS Code G0010 for Hepatitis Vaccine April 1, 2011

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Thursday, March 24, 2011

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Effective April 1, 2011, for services furnished on and after January 1, 2011, providers should report HCPCS code G0010 for administration of Hepatitis B vaccine in an outpatient facility setting instead of CPT codes 90471 and 90472. This will ensure that cost-sharing waivers for Preventive Services are correctly applied to the vaccine administrations.

Here is the complete CMS announcement:

"Please note that a correction has been issued by CMS to the Preventive Services Table (via Change Request #7012), with specific regard to CPT codes 90471 and 90472.  Beginning Friday, April 1, for services that were or are furnished on or after Saturday, January 1, 2011, when providers are furnishing Hepatitis B Vaccines in outpatient  facility settings they must report HCPCS code G0010 (Administration of Hepatitis B vaccine) rather than CPT code 90471 or 90472.  This is in order to ensure that cost-sharing waivers are correctly applied to vaccine administration.  As of Friday, April 1, CR 7012 will no longer recognize CPT codes 90471 and 90472 for applying cost-sharing waivers on claims submitted for preventive services."

Link to Transmittal 864 (CR 7012)

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This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.