Ask ‘What About Vaccines?’ Every Time

Vaccines are one of the safest and most convenient ways to prevent disease and maintain good health. IPRO urges providers to remember the WAVE acronym. This encourages providers to ask: “What About Vaccines?” Every Time, at every patient encounter. Opening a dialogue about vaccines is the first step toward protecting the health and well-being of both patients and providers.

Vaccine Recommendations

Vaccine recommendations are subject to change in response to new variants, or as new formulations become available. Check the Centers for Disease Control and Prevention (CDC) for updated recommendations regarding:
Immunization schedules
Pneumococcal disease
Respiratory syncytial virus (RSV)

Paying for Vaccines

Most commercial insurance provides coverage for the COVID-19 vaccine. Medicare Part B covers vaccines and vaccine administration for:
• Pneumonia
• Hepatitis B (for individuals at high and intermediate risk)
Certain reasonable and necessary vaccines to treat an injury or exposure to a disease

Medicare Part D covers the RSV vaccine.

The Bridge Access Program provides free coverage for COVID-19 vaccines for uninsured and underinsured adults.

Billing and Payment Resources

Billing for Vaccines in Skilled Nursing Facilities

AMDA and the Moving Needles Initiative released this guide to provide information to assist with vaccine coding and billing in the long-term care setting.

Billing Medicare for Respiratory Vaccines

This CMS document explains how Medicare pays for respiratory vaccines administered during a patient’s stay in a nursing home.

Medicare Billing Guidance

This ACHA/NCAL tool provides Medicare billing guidance for respiratory vaccines in LTC.

NAIIS Vaccine Insurance Coverage of Adult Immunization

The National Adult and Influenza Immunization Summit (NAIIS) created this decision tree which walks the provider through the vaccine billing process for patients with and without insurance.

WAVE Campaign Tools

Did you know…

IPRO Offers Assistance with Vaccines and Clinics at Your Facility
IPRO can connect nursing homes with local community pharmacies to provide
access to vaccines and assistance with internal or community clinics. For more information,
please contact IPRO at or call us toll-free at 888-502-0566.