CMS Manual System

CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 11163 Date: December 14, 2021 Change Request 12439 Transmittal 11163, dated December 14, 2021, is being rescinded and replaced by Transmittal 11329, dated, March 29, 2022 to revise business requirement All other information remains the same. SUBJECT: Claims Processing Instructions for the New Pneumococcal 15-valent Conjugate Vaccine Code 90671 and Pneumococcal 20- valent Conjugate Vaccine Code 90677.

12439.2 MACs shall develop payment allowance limits for pneumococcal vaccine code 90671 when CMS does not supply the payment allowance limit on the ASP drug pricing file at the contractors’ discretion. X X X 12439.3 Contractors shall pay for pneumococcal conjugate vaccine codes 90671 and 90677 to hospitals (12X and

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