Happy Immunization Awareness Month!

Summer is ending. Your practice has been busy performing all the annual preventive exams that parents are trying to squeeze in before they gleefully send their kids back to school. It makes sense that August is National Immunization Awareness month. Immunizations help to protect everyone, especially our most vulnerable and sick, from contracting preventable diseases.

Best Billing Practices

For the Kids: If your practice is in the state of Massachusetts, there is a program for children and adolescent vaccines through the age of 18 for both Commercial and Medicaid eligible patients. All Category A ACIP vaccines are covered. You can keep costs down for your practice and prevents claims denials by properly obtaining these vaccines from the MDPH for patients ages birth through eighteen. The Massachusetts Department of Public Health (MDPH) issues notices when there are shortages.

• Obtain these vaccines from the state for all child and adolescent patients – to find out more please follow this link from the MDPH, or take a look at their helpful FAQ.
• Affix modifier SL (state supplied) to the Vaccine CPT code for all claims submitted for vaccines procured from the DPH.
• We understand that sometimes the state runs out! If there is a vaccine shortage, you can bill for a privately purchased vaccine; documentation from the DPH should be produced to prevent claims denials.

For Adults: NHP covers and reimburses all recommended vaccines and immunizations that are FDA approved

• We cover travel immunizations
• If a patient turns 19 during the HPV Vaccine series, NHP will cover the rest of the series
• We will reimburse a vaccine provided without an E/M service

NHP provides our network with a variety of payment policies that your billing staff should be familiar with. Our polices for Vaccine and Immunizations and Modifiers are linked. If you have any questions, please reach out to our provider service team at providerservice@nhp.org!