Starting January 25, 2021, the Family Medicine section of the MSC Payment Schedule added the following temporary fee codes:
T10042 COVID-19 immunization (with visit)
$5.43
Guidelines
- Payable for COVID-19 immunization (make sure you set the ICD-9 to C19)
- Payable in full with a visit
- If the main reason you’re seeing the patient is just for immunization then you should bill 10043 (immunization without a visit) or 10044 (extended immunization)
TB10043 COVID-19 immunization (without visit)
$14.00
Guidelines
- Payable for COVID-19 immunization (make sure you set the ICD-9 code to C19)
- Not payable with a visit
TB10044 Extended COVID-19 immunization (extra)
$17.62
Guidelines
- Payable for an extended COVID-19 immunization (make sure you set the ICD-9 code to C19)
- Paid only with 10043 if you’re with the patient for more than 10 minutes
- Make sure you enter the start and end times on both the billing claim and the patient’s chart
- Not eligible if part of a health authority immunization program
- Can only be authorized by you, not a nurse or other employee
If you have any questions about the above Immunization Services don’t hesitate to reach out to our team.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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