Wellcare is offering Primary Care Physicians (PCPs) an enhanced payment of $20 for every flu shot they administer to members this fall.
PCPs will receive the additional reimbursement for submitting detailed claims for each patient visit related to the Centers for Medicare & Medicaid Services (CMS) Star measure: annual flu vaccine.
We will offer an enhanced payment of $20 per code for select codes (including CPT Category II codes) with dates of service from October 1, 2024 to December 31, 2024.
Receive Payment in March 2025
Claims must be received by February 28, 2025. A one-time payment will be sent out in March 2025.
The Enhanced Payment Program is in addition to the compensation arrangement in your participation agreement in our provider network and the other Wellcare incentive programs you participate in.
Please refer to the detailed listing of measures and codes for specific services eligible for enhanced payment.
|
STAR MEASURE |
STANDARD |
ELIGIBLE CODES* |
|
Annual Flu Vaccine |
The percentage of members who received an influenza vaccination between July 1 of the measurement year and the date when the CAHPS 5.0 H survey was completed. |
Current eligible codes include: 90653, 90656, 90657, 90658, 90660, 90661, 90662, 90673, Q2039, G0008, M0201 |
*Eligible codes for this program may change and this program will follow Centers for Medicare & Medicaid Services (CMS) guidelines.
Questions?
If you have any questions, please call Wellcare Provider Services at 1-855-538-0454 or visit the Secure Provider Portal. Our Provider Engagement staff can also help. Visit the Find Your Account Manager tool to find who supports your specialty and region. Keep up with the latest Wellcare provider updates by reviewing and bookmarking Provider Bulletins.
