BlueCross BlueShield of South Carolina

Billing for the Administration of the Influenza Virus Vaccine

October 29, 2010

Effective October 1, 2010, BlueCross BlueShield of South Carolina began providing coverage for the seasonal influenza virus vaccine and its administration. This is part of our preventive immunization services. We cover one vaccination per year. We will cover additional influenza vaccines (i.e., the number of doses of a vaccine and/or the type of influenza vaccine) when they are deemed to be medically necessary. BlueCross will cover the vaccine and its administration for all fully insured members who have immunization benefits as part of their health plans.
 
The level of coverage for the administration of the flu vaccination will depend on the member’s preventive benefits. 
 
If the member has preventive benefits, we will cover the administration and vaccine for the seasonal flu shot at 100 percent of the allowable with no age limits, deductible, coinsurance, copayment, etc.
If the member does not have preventive benefits, BlueCross will cover the administration and vaccine for the seasonal flu shot subject to the member’s deductible, coinsurance or copayment.
 
Verify the member’s benefits by logging into My Insurance Manager^SM or by calling Provider Services at 800-334-2583.
 
The H1N1 vaccine is now combined with the influenza vaccine. BlueCross will not cover stand-alone H1N1 vaccines and administrations.
 
BlueCross will not cover office visit charges when the sole purpose of the visit is to administer the seasonal vaccine(s).

Vaccination Payments

Here are the vaccination and administration codes:

Vaccine Codes, Administration and Dosage Schedule

Here is the most recent information available on the recommended vaccine dosage and administration: