top of page
Sources: 42 C.F.R. § 411.355(h)
12. Preventive Screening Tests, Immunizations and Vaccines
Preventive screening tests, immunizations, and vaccines that meet the following conditions:
-
They are subject to CMS-mandated frequency limits;
-
The arrangement does not violate the anti-kickback statute or any laws or regulations governing billing or claims submission;
-
All billing and claims submission for the preventive screening tests, immunizations, and vaccines does not violate any Federal or State law or regulation governing billing or claims submission; and
-
The preventive screening tests, immunizations, and vaccines must be covered by Medicare and must be listed as eligible for this exception on the List of CPT/HCPCS Codes.
Stark General Exception
bottom of page