Provider Manual
20 PRESCRIPTION DRUG COVERAGE
20.5 Vaccines and Vaccine Administration Coverage Under Part B Benefits
Medicare Part B (Medical) benefits include the following routine immunizations:
Providers who have a supply and administer the vaccine in their office should collect the member’s copay at time of service and submit the claim for the vaccine and administration on a CMS 1500 (08-05) form to:
IntegraNet Health
Attn: Claims Department
2900 North Loop W, #700
Houston, TX 77092