What is roster billing and downloading the roster form

Roster billing is a quick and convenient way to bill for flu and pneumonia vaccinations. To submit a roster bill, a home health agency must have provided the same type of vaccination to five or more people on the same date of service. Each type of vaccination must be billed on a separate roster bill. You cannot have pneumococcal pneumonia vaccines (PPVs) and flu vaccines on the same roster bill.

Roster billing enables Medicare beneficiaries to participate in mass pneumococcal and influenza virus vaccination programs offered by various entities that give vaccines to a group of beneficiaries. Learn more about this simplified process.

Immunization roster billing

Roster billing may be used when immunizations are offered for large groups of beneficiaries in Public Health Centers (PHCs), shopping malls, grocery stores, senior citizen homes, or health fairs.

• Roster billing is not available for hepatitis B vaccinations.
• Roster billing does apply to influenza and pneumococcal immunizations.

Roster billing for Part A providers

Part A providers who use direct data entry (DDE) pdf file can submit roster bills by following the steps below:
• To access the roster bill entry page, choose option "2" claims/attachments) and then select option "87" (roster bill entry).
• The page allows providers to enter pneumococcal and influenza vaccinations in a roster bill form. When completing the roster bill, providers should observe the following points:

• Only one date of service per roster page
• A maximum of 10 patients per roster page may be reported on a DDE roster page
• Press F9 to transmit the claim

Roster billing for Part B providers
To enable Medicare beneficiaries to participate in mass pneumococcal and influenza virus vaccination programs offered by PHCs and other individuals and entities that give vaccines to a group of beneficiaries, the simplified roster billing process was developed.

• Influenza virus vaccine: Roster sheet pdf file
http://medicare.fcso.com/Forms/137489.pdf

• Pneumococcal pneumonia virus vaccine: Roster sheet
http://medicare.fcso.com/Forms/138380.pdf