Novitas implemented provider enrollment relief for providers impacted by COVID-19, retroactive to March 1, 2020.
CMS has identified the codes for billing COVID-19 vaccines, administrations and therapeutic treatments. You must be enrolled in the Medicare program to perform and bill for these services when provided to Medicare beneficiaries.
Note: When vaccines are provided by the government to you free of charge, you may only bill for the administration. Do not include the vaccine codes on the claim.
We have established the provider enrollment hotline at 855-247-8428, option 2, available 8:30 a.m. - 4 p.m. ET . Please contact the hotline if you need to enroll as an eligible provider for billing COVID-19 vaccines..
Below are all supplier types who do not need to separately enroll to bill for COVID-19 vaccine administrations:
Institutional:
Hospital
Hospital outpatient department
Skilled nursing facility (includes Parts A and B)
Critical access hospital
End-stage renal disease facility
Home health agency
Hospice
Comprehensive outpatient rehabilitation facility
Federally qualified health center
Rural health clinic
Indian health services facility
Non-Institutional:
Physician
Non-physician
Clinic/group practice
Pharmacy (enrolled as Part B)
Mass immunizer (roster bill only)
If you are not on the above list, you can temporarily enroll to bill for COVID-19 vaccine administrations via the hotline.
If you’re calling to initiate temporary billing privileges, you will receive the approval or rejection decision during the call, followed by a decision letter. Please ensure you have all necessary information available at the time of the call:
Legal business name
National provider identifier
Tax identification number
Practice location and state license, if applicable
For a list of eligible provider types, please see the CMS Enrollment for administering COVID-19 vaccine shots webpage.
Centralized billing allows for mass immunizers to submit roster bill claims to one Medicare administrative contractor (MAC). To be a centralized biller, you must operate in at least three MAC jurisdictions.
To become a centralized biller, please contact the provider enrollment hotline at 855-247-8428, option 2. Have the following information available for the call:
Estimate of how many patients to whom you expect to administer the COVID-19 shot.
Approximate dates of shots.
List of states for COVID-19 vaccination clinics.
Type of services you generally deliver other than preventive vaccinations, if any.
If you employ nurses who will administer the COVID-19 shot or if you hired them specifically to give these shots.
Names and addresses of all entities operating under provider application.
Contact information for the centralized billing program designated contact.
Additional information
Please visit the CMS Enrollment for administering COVID-19 vaccine shots webpage for more information on enrolling to administer the COVID-19 vaccines.