2015-2016 Seasonal Flu Vaccine Pricing Released

2015-2016 Seasonal Flu Vaccine Pricing Released

School is in session, and you know what that means: Flu and cold season is off and running! Patients will soon be coming to your physician office in droves to receive their influenza and, possibly, pneumococcal vaccines.

Below are the 2015-2016 payment allowances for the listed CPT® and HCPCS Level II Q codes when payment is based on 95 percent of the Average Wholesale Price (i.e., furnished outside the hospital outpatient department).

CPB : Online Medical Billing Course

CPT® Payment allowance Effective Date
90630 $23.467 8/1/2015-7/31/2016
90654 pending 8/1/2015-7/31/2016
90655 pending 8/1/2015-7/31/2016
90656 $13.880 8/1/2015-7/31/2016
90657 $6.022 8/1/2015-7/31/2016
90661 $22.288 8/1/2015-7/31/2016
90662 $36.315 8/1/2015-7/31/2016
90672 pending 8/1/2015-7/31/2016
90673 $37.193 9/26/2015-7/31/2016
90685 $24.596 8/1/2015-7/31/2016
90686 $18.155 8/1/2015-7/31/2016
90687 $9.134 8/1/2015-7/31/2016
90688 $18.269 8/1/2015-7/31/2016
HCPCS Level II Payment Allowance Effective Date
Q2035 $13.025 8/1/2015-7/31/2016
Q2036 pending 8/1/2015-7/31/2016
Q2037 $15.830 8/1/2015-7/31/2016
Q2038 $12.044 8/1/2015-7/31/2016

The payment allowance for Q2039 Flu vaccine adult – not otherwise classified is determined by local contractors, with an effective date of August 1, 2015 through July 31, 2016.

CPT® 90655 and 90672 payment allowances are pending. These payment allowances will be published in the Centers for Medicare & Medicaid Services influenza vaccine pricing webpage.

See the Morbidity and Mortality Weekly Report for “Recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 Influenza Season.”

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Renee Dustman

Renee Dustman

Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.
Renee Dustman

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Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.

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