Medicare increases payment allowances for seasonal flu vaccine

The Centers for Medicare & Medicaid Services (CMS) has released the Medicare payment allowances for seasonal flu vaccine for the 2023–2024 season (dates of service from Aug. 1, 2023, through July 31, 2024).

The 14 different flu vaccine products on the market all received modest year-over-year payment increases. For example, the payment allowance for Sanofi Pasteur’s Fluzone High-Dose Quadrivalent vaccine (code 90662) rose from $69.941 to $73.403 (an increase of about 5%).

As a reminder, Part B deductible and coinsurance amounts don’t apply for flu vaccines. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must accept assignment on the claim for the vaccine.

Also, these allowances are for the vaccine products only. Clinicians should also report G0008 (“administration of influenza virus vaccine”) to Medicare to claim the separate allowance for administering the vaccine.

For more information:

• CMS “Flu Shot” webpage: frequency, coverage, billing, coding, and resources
• CMS manual: Instruction to your Medicare Administrative Contractor

— Kent Moore, AAFP Senior Manager for Payment Strategies

Posted on Aug. 24, 2023