This article is for health care providers who bill for seasonal vaccinations (flu, RSV, COVID-19, pneumonia, and others)
Blue Cross Blue Shield of Massachusetts covers routine vaccines, such as those for COVID-19, flu and RSV, to help our members remain healthy.
Our vaccine coverage is based on medical evidence as well as guidelines and vaccine specific recommendations from the Massachusetts Department of Public Health and national medical specialty organizations*.
Routine vaccinations are covered at no cost to most of our members when administered by an in-network provider or in-network pharmacy. We recommend that you always check member benefits and eligibility before performing services.
Who can administer vaccines?
Administration of all vaccines are in accordance with DPH guidance. Vaccines administered at pharmacies are covered the same as if they are administered at a doctor’s office or by other providers in our network.
Resources
For complete billing and reimbursement information, refer to the following payment policies:
Resources
For complete billing and reimbursement information, refer to the following payment policies:
- Immunizations payment policy
- COVID-19 payment policy
To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or log in and go to Office Resources>Policies & Guidelines>Payment Policies.
For information on pharmacy benefits for vaccines and Medicare Part D coverage, refer to our Vaccines page.
*The American College of Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Infectious Diseases Society of America.
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