Medicare Pricing Released for Most Flu Vaccine Codes

Flu Shot Reimbursement

For information on Fall 2013 through Spring 2014 Flu Vaccine Coding and Billing information, go to our September 24th post here.

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Medicare pricing for flu vaccines were released September 28th and appear below for all HCPCS codes which were published with fees. For more information on billing for these vaccines, see our post here.

NEW for 2012-2013! 90653 – Influenza virus vaccine, inactivated, subunit, adjuvanted, for intramuscular use (Medicare reimbursement not yet published)

90654 Influenza virus vaccine, split virus, preservative-free, for intradermal use (Medicare reimbursement $18.91)

90655 Influenza virus vaccine, trivalent, preservative free, when administered to children 6-35 months of age, for intramuscular use (Medicare reimbursement $16.45) single dose syringe

90656 Influenza virus vaccine, trivalent, preservative free, when administered to individuals 3 years and older, for intramuscular use (Use for Medicare flu shots using the vaccine Fluarix) (Medicare reimbursement $12.39) single dose syringe

90657 Influenza virus vaccine, trivalent, when administered to children 6-35 months of age, for intramuscular use (Medicare reimbursement $6.02) multi-dose vial

90658 Influenza virus vaccine, trivalent, when administered to individuals 3 years and older, for intramuscular use (not recognized by Medicare) multi-dose vial

90660 Influenza virus vaccine, live, for intranasal use (Medicare reimbursement $23.45)

90662 Influenza virus vaccine, trivalent, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use (Medicare reimbursement $30.92) high dose

90672 Influenza virus vaccine, quadrivalent, live, for intranasal use (not recognized by Medicare)

90685 Influenza virus vaccine, quadrivalent, preservative free, when administered to children 6-35 months of age, for intramuscular use (not recognized by Medicare)

90686 Influenza virus vaccine, quadrivalent, preservative free, when administered to individuals 3 years and older, for intramuscular use (not recognized by Medicare)

90687 Influenza virus vaccine, quadrivalent, when administered to children 6-35 months of age, for intramuscular use (not recognized by Medicare)

90688 Influenza virus vaccine, quadrivalent, when administered to individuals 3 years and older, for intramuscular use (not recognized by Medicare)

 

Only for Medicare Patients:
NEW for 2012-2013! Q2034 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Agriflu) (Medicare reimbursement not released)

Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria) (Medicare reimbursement $11.54)

Q2036 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval) (Medicare reimbursement $9.83)

Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirun) (Medicare reimbursement $14.05)

Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone) (Medicare reimbursement $12.04)

Q2039 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Not Otherwise Specified) (No reimbursement rate specified)

Posted in: Medicare & Reimbursement, Medicare This Week

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