Effective with dates of service on or after January 1, 2022, Mercy Care is responsible to process and pay for the COVID-19 vaccine and its administration (including approved booster doses) for Mercy Care Advantage member. There is no cost sharing responsibility for Mercy Care Advantage members who receive COVID-19 vaccinations.
Network providers and suppliers eligible to bill under Medicare Part B for vaccine administration need to account for this billing change. Please ensure administrative staff responsible for billing have been educated on this change to help avoid billing errors and payment delays.
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COVID-19 vaccine administration claims for Mercy Care Advantage patients with dates of service on or after January 1, 2022, need to be submitted to Mercy Care for payment. Do not submit to these claims to the original Medicare Fee-for-Service program for payment, they will be denied.
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COVID-19 vaccine administration claims for Mercy Care Advantage members with dates of service occurring in 2021, need to be submitted to the original Medicare Fee-for-Service program for payment. Do not submit to these claims to Mercy Care, they will be denied.
The Centers for Medicare and Medicaid Services (CMS) communicated this payment responsibility change for Medicare Advantage Organizations on October 8, 2021 in an HPMS memo.
For more information about Medicare Part B Payment for COVID-19 Vaccines and Certain Monoclonal Antibodies during the Public Health Emergency, please reference the following link:
Additional Resources
CMS has released a toolkit for providers related to COVID-19. Please click on the link to access.
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