The Schedule of Medical Benefits (SOMB) is adding two COVID-19 vaccination codes effective March 15th, 2021. Both codes are exempt from the daily cap but need time to be updated to the Claim Assessment System (CLASS), so please hold 13.59V and 13.59VA until further notice. If you’re submitting claims through Dr.Bill, submit them as normal and we’ll hold them in our system until AHCIP gives us the go-ahead.
HSC COVID-19 Vaccine Fee Codes
- HSC 13.59V ($25) – Immunization and administration of COVID-19 vaccine
Guidelines:
- You can claim 13.59V if it’s provided by an eligible health care provider under your direct supervision or if you’re present and immediately available.
- You can claim for vaccine appointments that take less than 10 minutes.
- Make sure you check your patient’s records and confirm that the vaccine dose is correctly sequenced (so patients don’t get more than one dose unless it’s medically needed).
- HSC 13.59VA ($20) – Prolonged COVID-19 vaccination
Guidelines:
- You can claim 13.59VA along with 13.59V for any vaccine appointments that take more than 10 minutes.
If you have any questions about this change, please get in touch.
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