Gardisil and zoster vaccines

What are you doing for patients who need gardisil or the zoster vaccines? Do you check with their insurance for eligibility and coverage for each one? Do you write prescriptions and have them pick up the drug at the drugstore? (I haven't looked to see at what temperature these serums have to be kept.) Do you insist on collecting at the time of service if no coverage?

And, what about state Medicaid or state supplied vaccination programs: anyone covering the gardisil for girls?

Thanks so much.

Zostovax and Gardisil

I work for the "Travel Advisory and Immunization Clinic" in Rockville Maryland. When it comes to these two vaccines our clinic is not affiliated with any insurance companies so we bill the patient upon receipt of the vaccine. We store the vaccine here in our office and administer it. We supply the patient with a CPT® code and ICD9 code if they ask. Some have been skilled enough to get reimbursed by their insurance companies and others have not been so lucky. The few female patients we have through our Internal Medicine practice we do bill their health insurance companies.

Gardasil immunization

This is a little late but hope it's helpful anyway. Our office always checks the patients insurance for coverage and benefits prior to the patient receiving the injection. The patient is informed before their appointment of their benefits. If it is not covered, payment is due the day of the administration. If a patient will owe a portion of the charge, this is calculated and must be paid up front as well. Some insurances offer pt responsibility calculators on their websites which are helpful. We stock the Gardasil in the office. As a gyn, we do not give the immunization to anyone under 19, they get it from their pedicatrician and we do not give it to Medicaid patients, they get it throught the Health Dept in our area.

Zostavax- don't get me started

Zostavax is the first routine vaccine that Medicare has deemed to be not a Part B covered vaccine. Neither the vaccine nor the administratio can be charged to Medicare.
Rather than rehash my feelings, go here http://tinyurl.com/l9rv5u
and you can see my writings on the topic. It is a must-read for any physician office that gives Zostavax

gardasil and 99211

Can these vaccines be billed with a 99211 as well. Recommendations from Merck are the patient wait for 15 minutes and monitored or checked to be sure no issues...eg fainting. Then checked by DR. Would this support a 99211 or would that be included in the adminstration portion. Thoughts?

99211

Do not bill separately

99211 and immunization administration

The CPT Assistant in July 2005 clarified that all of the pre work and post work of vaccine admin was included in the payment for vaccine admin and a nurse visit should not be billed in addition.