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Where do I submit bills for Medicare Advantage patients for COVID-19 administration services, vaccines, and monoclonal antibody products?

COVID-19 administration services, FDA-approved vaccines, and FDA-approved monoclonal antibody products that are used to help the body fight or slow the virus’s growth which are performed in calendar years 2020 and 2021 for Medicare Advantage patients must be submitted to Original Medicare through your local Medicare Administrative Contractor (MAC).  This policy is changing for 2022.  CMS announced that effective for dates of service on and after January 1, 2022, COVID-19 administration services, vaccines, and monoclonal antibody products provided to Medicare Advantage patients must be submitted to the Medicare Advantage plan.  When these services are payable by Medicare, there is no expected cost-sharing for the patient.

Further information may be found at the links listed below.

CMS Announcement in the MLN Connects, December 16, 2021:
https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2021-12-16-mlnc#_Toc90391087

Medicare Billing for COVID-19 Vaccine Shot Administration:
https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration

CMS site for Monoclonal Antibody COVID-19 Infusion:
https://www.cms.gov/medicare/covid-19/monoclonal-antibody-covid-19-infusion

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