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COVID-19 PHE Extension & Flu & Pneumococcal Vaccines Updates for September 2021

Flu & Pneumococcal Vaccines Updates for September 2021

Flu & Pneumococcal Vaccines are Expanded SNF Enforcement Discretion for Certain Pharmacy Billing effective from 09/20/2021.

CMS exercised enforcement discretion for Skilled Nursing Facility (SNF) consolidated billing provisions related to flu and pneumococcal vaccines. 

This allows Medicare-enrolled immunizers, including pharmacies, to bill directly and get direct reimbursement from the Medicare program (including vaccine administration and product), whether these vaccines are administered at the same time (co-administered) with a COVID-19 vaccine or at different times. 

COVID-19 National Public Health Emergency Extension

The U.S. Department of Health and Human Services has extended the COVID-19 national public health emergency by another 90 days. 

And it was scheduled to end Oct. 17, 2021 and now it has been scheduled through Jan. 15, 2022.

The extension is applicable for following services,

  • Cost share waivers – Testing
  • Cost share waivers – Treatment
  • Cost share waivers – Transportation
  • Cost share waivers – Medicare Advantage Professional Services
  • Telehealth cost share – COVID-19
  • Telehealth cost share – Non-COVID-19
  • Telehealth expansion
  • Timely filing and prescription refills
  • Referrals and provisional credentialing
  • Prior authorization

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