Part B Insider (Multispecialty) Coding Alert

Published on Tue Aug 23, 2011 PDF

Plus: This MAC may accidentally double-request overpayments.

Good news for physicians who administer flu shots--CMS seems inclined to give practices a break with some of its recent updates to the seasonal influenza vaccines pricing, which is in effect from Sept. 1, 2011 through Aug. 31, 2012. CMS boosted payment for three codes and kept pay the same for two.

The Part B payment changes related to flu vaccines are as follows:

• 90654 -- Influenza virus vaccine, split virus, preservative-free, for intradermal use: $18.383 --" this is a new code for 2011, so no comparison fee exists
• 90655 -- Influenza virus vaccine, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use - $15.705 (up from $14.858 last year)
• 90656 -- Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use - $12.375 (the same as last year)
• 90657 -- Influenza virus vaccine, split virus, when administered to children 6-35 months of age, for intramuscular use - $6.653 (up from $6.297 last year)
• 90660 -- Influenza virus vaccine, live, for intranasal use - $22.316 (the same as last year)
• 90662 -- Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use - $30.923 (up from $29.213 last year)

For more on CMS's flu shot pricing, visit www.cms.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp.