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In the preamble to the1990 rule, we stated that, [f]or Medicare payment purposes, the hepatitis B vaccine may be administeredupon the order of a doctor of medicine or osteopathyby qualified staff of home health agencies, skilled nursing facilities, ESRD facilities, hospital outpatient departments, HMOs, persons recognized under the `incident to physician's services' provision of the law (section 1861(s)(2)(A) of the Act), as well as doctors of medicine and osteopathy. This policy is included in the Medicare Claims Processing Manual, Chapter 18, section 10.1.3

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