2010-11 Seasonal Flu Vaccine Rates

You can find 2010-2011 seasonal influenza vaccine pricing posted on the Centers for Medicare & Medicaid Services (CMS) website. These payment allowances also were published as a part of the October 2010 quarterly Average Sales Price (ASP) Drug Pricing files.

The payment allowance effective for service dates between Sept. 1 and Dec. 31:

CPT® Code Description Payment
90658 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use $11.368

The payment allowance effective for service dates between Sept. 1 and Aug. 31, 2011:

CPT® Code Description Payment
90655 Influenza virus vaccine, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use $12.398
90656 Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use $12.375
90657 Influenza virus vaccine, split virus, when administered to children 6-35 months of age, for intramuscular use $6.297
90660 Influenza virus vaccine, live, for intranasal use $22.316
90662 Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use $29.213

Annual Part B deductible and coinsurance amounts do not apply for the flu virus and pneumococcal vaccines.

The Medicare Part B payment allowance limits for seasonal flu and pneumococcal vaccines are 95 percent of the average wholesale price (AWP) as reflected in the published compendia, except where the vaccine is furnished in a hospital outpatient department, at which time the payment allowance is based on reasonable cost.

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