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.
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