Medicare HETS 270/271 Submitters:
CMS announces that the HETS 270/271 eligibility system is, effective today, April 13, 2020, once again supporting Pneumococcal Pneumonia Vaccination (PPV) HCPCS codes 90670 and 90732. In order to receive PPV data in the 271 response, HETS submitters must:
- Submit HCPCS code(s) 90670 and/or 90732 in the 270 request
- Ensure that the Medicare Beneficiary has active Medicare Part B Entitlement and does not have a Date of Death on file at the time of the 270 request
Please refer to Section 7.10.2 of the HETS 270/271 Companion Guide (version 10-16) (PDF) for information about the HETS PPV response. Please take special note that HETS now returns prior service history for PPV HCPCS codes 90670 and/or 90732. If the Medicare Beneficiary has received these vaccinations in the past (and the two criteria in the bulleted list above are met) then HETS will return up to ten historical date(s) of service and the rendering NPI for each relevant HCPCS code as necessary. The PPV service history would appear at the very bottom of the HETS 271 response. If no prior PPV service history is on record then HETS will not return PPV data; HETS does not return next eligible dates for PPV HCPCS codes.
Please contact the MCARE Help Desk if you have any questions or comments.