Are You Ready for the 2023-24 Influenza Season?
For the 2023-2024 influenza season, which runs from Aug. 1 through July 31, the Centers for Disease Control and Prevention (CDC) recommends everyone 6 months of age and older receive a flu vaccine “ideally by the end of October.” This advice has not changed from previous years, but the Medicare Part B payment allowances for the flu vaccines have changed.
Flu Vaccination Coding and Billing
For the most part, Medicare Part B payment allowances increased slightly for the 2023-2024 flu season, as shown in Table A.
Table A: CPT® code and Medicare Part B payment allowances for 2023-2024 flu season
|Code||Labeler Name||Vaccine Name||Payment Allowance|
|90662||Sanofi Pasteur||Fluzone High-Dose Quadrivalent||$73.403|
|90674||Seqirus||Flucelvax Quadrivalent (Preservative Free)||$34.172|
|90682||Sanofi Pasteur||Flublok Quadrivalent (Preservative Free)||$73.403|
|90686||GlaxoSmithKline||Fluarix Quadrivalent (Preservative free) Flulaval Quadrivalent (Preservative Free)||$22.350|
|Sanofi Pasteur||Fluzone Quadrivalent (Preservative Free)|
|Seqirus||Afluria Quadrivalent (Preservative Free)|
|90687||Sanofi Pasteur||Fluzone Quadrivalent 0.25ml (2023/2024)||$10.439|
|Seqirus||Afluria Quadrivalent 0.25ml|
|90688||Sanofi Pasteur||Fluzone Quadrivalent||$20.878|
|90694||Seqirus||Fluad Quadrivalent (Preservative Free)||$77.359|
The Medicare Part B payment allowance limits for influenza vaccines are 95 percent of the average wholesale price (AWP) except when the vaccine is furnished in a hospital outpatient department, rural health clinic (RHC), or federally qualified health center (FQHC), where payments are based on reasonable cost.
Annual Part B deductible and coinsurance amounts do not apply for influenza virus vaccinations.
For Medicare, report ICD-10-CM code Z23 Encounter for immunization on the claim and the administration code G0008 Administration of influenza virus vaccine. Unlike the vaccine product pricing, which is updated Aug. 1, the pricing for G0008 is effective Jan. 1 through Dec. 31.
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