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Hepatitis B Virus (HBV) Vaccine and Administration

Medicare covers flu, pneumococcal, and Hepatitis B shots. Flu, pneumococcal infections, and Hepatitis B can be life threatening to an older person. This is especially important for those who have chronic illness, including heart disease, lung disease, diabetes, or End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). People at medium to high risk for Hepatitis B should get Hepatitis B shots.

HCPCS/CPT Codes


90739 – Hepatitis B vaccine, adult dosage (2 dose schedule), for intramuscular use

90740 – Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use

90743 – Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use

90744 – Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use

90746 – Hepatitis B vaccine, adult dosage (3 dose schedule), for intramuscular use

90747 – Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use

G0010 – Administration

ICD-10-CM (ICD-9-CM) Codes


Z23 (V05.3)

Who Is Covered


Medicare covers the hepatitis B vaccine for certain beneficiaries who are at intermediate to high risk for the hepatitis B virus (HBV). These individuals include health care professionals who have frequent contact with blood or blood-derived body fluids during routine work, those with End-Stage Renal Disease (ESRD), persons who live in the same household as an HBV carrier, and persons diagnosed with diabetes mellitus. Other situations could qualify a beneficiary as being at intermediate or high risk of contracting HBV.

NOTE: Medicare beneficiaries who are currently positive for antibodies for hepatitis B are not eligible for this benefit

Frequency


Scheduled dosages required

Beneficiary Pays


  • Copayment/coinsurance waived
  • Deductible waived

Frequently Asked Questions (FAQs)


Am I at medium or high risk for Hepatitis B?

These are some of the factors that put you at medium or high risk for Hepatitis B:

  • Hemophilia.
  • ESRD (End-Stage Renal Disease).
  • Diabetes.
  • Certain other conditions that increase your risk for infection, like if you live with someone who has Hepatitis B, or if you’re a health care worker and have frequent contact with blood or body fluids.

Other factors may increase your risk for Hepatitis B. Check with your doctor to see if you’re at medium or high risk for Hepatitis B.

Does Medicare cover the hepatitis B vaccine for all Medicare beneficiaries?

No, Medicare covers the hepatitis B vaccine for certain beneficiaries who are at intermediate to high risk for the hepatitis B virus (HBV). These individuals include health care professionals who have frequent contact with blood or blood-derived body fluids during routine work, those with End-Stage Renal Disease (ESRD), persons who live in the same household as an HBV carrier, and persons diagnosed with diabetes mellitus. Other situations could qualify a beneficiary as being at intermediate or high risk of contracting HBV.

Can I roster bill the seasonal influenza virus, pneumococcal, and hepatitis B vaccines?

No, you may roster bill only the seasonal influenza virus and pneumococcal vaccines. You cannot roster bill the hepatitis B vaccine.


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