Influenza and Pneumococcal Vaccines and Administration Reimbursement: Quarter 3
The following services are paid at 100 percent of the established fee schedule amount. Coinsurance and the annual deductible do not apply.
- Payment allowances for influenza vaccines are effective August 1, 2023, unless stated otherwise
- Influenza and pneumococcal vaccine payment allowances are subject to change on a quarterly basis*
- Administration payment allowances are updated annually on January 1
* Quarterly changes to influenza and pneumococcal vaccine payment allowances can be located on the CMS ASP Pricing Files website.
Influenza, and Pneumococcal Administration Codes and Fees
Following are the 2023 influenza and pneumococcal administration fees for dates of service January 1 – December 31, 2024.
|
CPT® Codes |
Description |
N.C. FSY 2024 Amount |
S.C. FSY 2024 Amount |
Va. FSY 2024 Amount |
W.Va. FSY 2024 Amount |
|---|---|---|---|---|---|
|
G0008 |
Admin influenza virus vaccine |
$31.01 |
$31.04 |
$32.05 |
$30.97 |
|
G0009 |
Admin pneumococcal vaccine |
$31.01 |
$31.04 |
$32.05 |
$30.97 |
Influenza Virus Vaccine National Fees Effective August 1, 2023 – July 31, 2024
The 2023/2024 flu season fees are listed below. Contractors are required to implement these fees no later than September 30, 2023. Palmetto GBA implemented the following fees on September 26, 2023, for dates of service August 1, 2023, and after. All claims processed and paid prior to September 26, 2023, will be automatically adjusted. No further action is required.
| CPT® Codes | Description | Aug. 1, 2023 – July 31, 2024 Amount |
|---|---|---|
|
90630* |
Flu vacc iiv4 no preserv id |
Pending |
|
90653 |
Iiv adjuvant vaccine im |
Pending |
|
90654* |
Flu vacc iiv3 no preserv id |
Pending |
|
90655* |
Iiv3 vacc no prsv 0.25 ml im |
Pending |
|
90656* |
Iiv3 vacc no prsv 0.5 ml im |
Pending |
|
90657* |
Iiv3 vaccine splt 0.25 ml im |
Pending |
|
90661* |
Cciiv3 vac no prsv 0.5 ml im |
Pending |
|
90662 |
Iiv no prsv increased ag im |
$73.40 |
|
90672 |
Laiv4 vaccine intranasal |
$27.79 |
|
90673* |
Riv3 vaccine no preserv im |
Pending |
|
90674 |
Cciiv4 vac no prsv 0.5 ml im |
$34.17 |
|
90682 |
Riv4 vacc recombinant dna im |
$73.40 |
|
90685* |
Iiv4 vacc no prsv 0.25 ml im |
Pending |
|
90686 |
Iiv4 vacc no prsv 0.5 ml im |
$22.35 |
|
90687 |
Iiv4 vaccine splt 0.25 ml im |
$10.44 |
|
90688 |
Iiv4 vaccine splt 0.5 ml im |
$20.88 |
|
90689* |
Vacc iiv4 no prsrv 0.25 ml im |
Pending |
|
90694 |
Quadrivalent(aIIV4) inactivated, adjuvanted, pres free, 0.5ml |
$77.36 |
|
90756 |
Cciiv4 vacc abx free im |
$32.37 |
|
Q2035* |
Afluria vacc, 3 yrs & >, im |
Pending |
|
Q2036* |
Flulaval vacc, 3 yrs & >, im |
Pending |
|
Q2037* |
Fluvirin vacc, 3 yrs & >, im |
Pending |
|
Q2038* |
Fluzone vacc, 3 yrs & >, im |
Pending |
|
Q2039 |
Influenza virus vaccine, nos |
Specify Drug Name; May Require Invoice |
COVID-19 Administration Code and Fees
Following are the 2023/2024 COVID-19 administration fees effective January 1, 2024.
|
CPT® Codes |
Description |
NC FSY 2024 Amount |
SC FSY 2024 Amount |
VA FSY 2024 Amount |
WV FSY 2024 Amount |
|---|---|---|---|---|---|
|
90480 |
Immunization administration by intramuscular inj. Coronavirus |
$41.35 |
$41.39 |
$42.74 |
$41.30 |
COVID-19 Vaccine National Fees Effective January 1, 2024
The 2024 COVID-19 fees are listed below.
| CPT® Codes | Description | Amount |
|---|---|---|
|
91318 |
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) 3mcg trs-suc im |
$65.55 |
|
91319 |
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) 10mcg trs-suc im |
$87.78 |
|
91320 |
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) 30mcg trs-suc im |
$131.10 |
|
91321 |
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) 25 mcg/.25ml im |
$145.92 |
|
91322 |
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) 50 mcg/0.5ml im |
$145.92 |
*Important: Please verify coding where a fee is pending. This is usually an indication that there are no sources available to establish a fee. If billing a code with fee pending, you will need to provide a valid NDC for the current 2023/2024 flu season. Your claim will be rejected if incorrectly coded. The following HCPCS code to NDC crosswalk is made available for your reference. Note that some sources listed in this cross-walk represent 2017/2018, 2018/2019, 2019/2020, 2021/2022 and 2022/2023 flu season vaccines. These resources could be rejected if provided during the current 2023/2024 flu season. This information is also located on the CMS ASP Pricing Files website.
Excerpt from CMS file: Oct 2023 AWP NDC-HCPCS Crosswalk_09192023.xlsx
|
CPT® |
Short Descriptor |
Labeler Name |
NDC |
Drug Name |
|---|---|---|---|---|
|
90653 |
Liv adjuvant vaccine im |
Seqirus Inc. |
70461-0019-03 |
Fluad (2019/2020) |
|
90653 |
Liv adjuvant vaccine im |
Seqirus Inc. |
70461-0020-03 |
Fluad (2020/2021) |
|
90662 |
Liv no prsv increased |
Sanofi Pasteur, Inc. |
49281-0405-65 |
Fluzone High-Dose (2019/2020) |
|
90662 |
Liv no prsv increased ag im |
Sanofi Pasteur, Inc. |
49281-0403-65 |
Fluzone High-Dose (2019/2020) |
|
90662 |
Liv no prsv increased ag im |
Sanofi Pasteur, Inc. |
49281-0120-65 |
Fluzone High-Dose Quadrivalent (2020/2021) |
|
90662 |
Liv no prsv increased ag im |
Sanofi Pasteur, Inc. |
49281-0121-65 |
Fluzone High-Dose Quadrivalent (2021/2022) |
|
90662 |
Liv no prsv increased ag im |
Sanofi Pasteur, Inc. |
49281-0122-65 |
Fluzone High-Dose (Pres Free) (2022/2023) |
|
90662 |
Liv no prsv increased ag im |
Sanofi Pasteur, Inc. |
49281-0123-65 |
Fluzone High-Dose Quadrivalent (2023/2024) (Pres Free) |
|
90670 |
PCV13 Vaccine IM |
Wyeth/Pfizer U.S. |
00005-1971-02 |
Prevnar 13 |
|
90670 |
PCV13 Vaccine IM |
Wyeth/Pfizer U.S. |
00005-1971-05 |
Prevnar 13 |
|
90671 |
PCV15 VACCINE IM |
Merck |
00006-4329-02 |
Vaxneuvance |
|
90671 |
PCV15 VACCINE IM |
Merck |
00006-4329-03 |
Vaxneuvance |
|
90672 |
Laiv4 vaccine intranasal |
MedImmune, LLC |
66019-0306-10 |
FluMist Quadrivalent (2019/2020) |
|
90672 |
Laiv4 vaccine intranasal |
MedImmune, LLC |
66019-0307-10 |
FluMist Quadrivalent (2020/2021) |
|
90672 |
Laiv4 vaccine intranasal |
MedImmune, LLC |
66019-0308-10 |
FluMist Quadrivalent (2021/2022) |
|
90672 |
Laiv4 vaccine intranasal |
MedImmune, LLC |
66019-0310-10 |
FluMist Quadrivalent (2023/2024) |
|
90674 |
CCIIV4 VAC NO PRSV 0.5 ML IM |
Seqirus Inc. |
70461-0319-03 |
Flucelvax Quadrivalent (2019/2020) (Pres Free) |
|
90674 |
CCIIV4 VAC NO PRSV 0.5 ML IM |
Seqirus Inc. |
70461-0320-03 |
Flucelvax Quadrivalent (2020/2021) (Pres Free) |
|
90674 |
CCIIV4 VAC NO PRSV 0.5 ML IM |
Seqirus Inc. |
70461-0321-03 |
Flucelvax Quadrivalent (2021/2022) (Pres Free) |
|
90674 |
CCIIV4 VAC NO PRSV 0.5 ML IM |
Seqirus Inc. |
70461-0322-03 |
Flucelvax Quadrivalent (2022/2023) (Pres Free) |
|
90674 |
CCIIV4 VAC NO PRSV 0.5 ML IM |
Seqirus Inc. |
70461-0323-03 |
Flucelvax Quadrivalent (2023/2024) (Pres Free) |
|
90677 |
PCV20 VACCINE IM |
Pfizer |
00005-2000-02 |
PREVNAR 20 |
|
90677 |
PCV20 VACCINE IM |
Pfizer |
00005-2000-10 |
PREVNAR 20 |
|
90682 |
RIV4 VACC RECOMBINANT DNA IM |
Sanofi Pasteur, Inc. |
49281-0719-10 |
Flublok Quadrivalent (2019/2020) |
|
90682 |
RIV4 VACC RECOMBINANT DNA IM |
Sanofi Pasteur, Inc. |
49281-0720-10 |
Flublok Quadrivalent (2020/2021) |
|
90682 |
RIV4 VACC RECOMBINANT DNA IM |
Sanofi Pasteur, Inc. |
49281-0721-10 |
Flublok Quadrivalent (2021/2022) |
|
90682 |
RIV4 VACC RECOMBINANT DNA IM |
Sanofi Pasteur, Inc. |
49281-0722-10 |
Flublok Quadrivalent (Pres Free) (2022/2023) |
|
90682 |
RIV4 VACC RECOMBINANT DNA IM |
Sanofi Pasteur, Inc. |
49281-0723-10 |
Flublok Quadrivalent (2023/2024) (Pres Free) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0519-25 |
Fluzone Quadrivalent 0.25ml (2019/2020) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Seqirus Inc. |
33332-0219-20 |
Afluria Quadrivalent 0.25ml (2019/2020) (Pres Free) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0520-25 |
Fluzone Quadrivalent 0.25ml (2020/2021) (Pres Free) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Seqirus Inc. |
33332-0220-20 |
Afluria Quadrivalent 0.25ml (2020/2021) (Pres Free) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0521-25 |
Fluzone Quadrivalent 0.25ml (2021/2022) (Pres Free) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Seqirus Inc. |
33332-0221-20 |
Afluria Quadrivalent 0.25ml (2021/2022) (Pres Free) |
|
90685 |
IIV4 VACC NO PRSV 0.25 ML IM |
Seqirus Inc. |
33332-0323-03 |
Afluria Quadrivalent 0.25ml (2023/2024) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
58160-0896-52 |
Fluarix Quadrivalent (2019/2020) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
19515-0906-52 |
Flulaval Quadrivalent (2019/2020) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0419-50 |
Fluzone Quadrivalent (2019/2020) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0419-10 |
Fluzone Quadrivalent (2019/2020) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Seqirus Inc. |
33332-0319-01 |
Afluria Quadrivalent (2019/2020) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
58160-0885-52 |
Fluarix Quadrivalent (2020/2021) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
19515-0816-52 |
Flulaval Quadrivalent (20202021) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0420-50 |
Fluzone Quadrivalent (2020/2021) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0420-10 |
Fluzone Quadrivalent (2020/2021) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Seqirus Inc. |
33332-0320-01 |
Afluria Quadrivalent (2020/2021) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
58160-0887-52 |
Fluarix Quadrivalent (2021/2022) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
ID Biomedical Corp |
19515-0818-52 |
Flulaval Quadrivalent (20212022) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0421-50 |
Fluzone Quadrivalent (2021/2022) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0421-10 |
Fluzone Quadrivalent (2021/2022) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Seqirus Inc. |
33332-0321-01 |
Afluria Quadrivalent (2021/2022) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
58160-0890-52 |
Fluarix Quadrivalent (2022/2023) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
19515-0808-52 |
Fluarix Quadrivalent (2022/2023) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0422-50 |
Fluzone Quadrivalent (2022/2023) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0422-10 |
Fluzone Quadrivalent (2022/2023) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Seqirus Inc. |
33332-0322-03 |
Afluria Quadrivalent (2022/2023) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
58160-0909-52 |
Fluarix Quadrivalent (2023/2024) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
GlaxoSmithKline |
19515-0814-52 |
Fluarix Quadrivalent (2023/2024) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0423-50 |
Fluzone Quadrivalent (2023/2024) (Pres Free) |
|
90686 |
IIV4 VACC NO PRSV 0.5 ML IM |
Seqirus Inc. |
33332-0323-03 |
Afluria Quadrivalent (2023/2024) (Pres Free) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0631-15 |
Fluzone Quadrivalent 0.25ml (2019/2020) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Seqirus Inc. |
3332-0419-10 |
Afluria Quadrivalent 0.25ml (2019/2020) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0633-15 |
Fluzone Quadrivalent 0.25ml (2020/2021) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Seqirus Inc. |
33332-0420-10 |
Afluria Quadrivalent 0.25ml (2020/2021) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0635-15 |
Fluzone Quadrivalent 0.25ml (2021/2022) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Seqirus Inc. |
33332-0421-10 |
Afluria Quadrivalent 0.25ml (2021/2022) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0637-15 |
Fluzone Quadrivalent 0.25ml (2022/2023) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Seqirus Inc. |
33332-0422-10 |
Afluria Quadrivalent 0.25ml (2022/2023) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Sanofi Pasteur, Inc. |
49281-0639-15 |
Fluzone Quadrivalent 0.25 mL (2023/2024) |
|
90687 |
IIV4 VACCINE SPLT 0.25 ML IM |
Seqirus Inc. |
33332-0423-10 |
Afluria Quadrivalent 0.25ml (2023/2024) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
GlaxoSmithKline |
19515-0897-11 |
Flulaval Quadrivalent (2019/2020) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0631-15 |
Fluzone Quadrivalent (2019/2020) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Seqirus Inc. |
33332-0419-10 |
Afluria Quadrivalent (2019/2020) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0633-15 |
Fluzone Quadrivalent (2020/2021) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Seqirus Inc. |
33332-0420-10 |
Afluria Quadrivalent (2020/2021) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0635-15 |
Fluzone Quadrivalent (2021/2022) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Seqirus Inc. |
33332-0421-10 |
Afluria Quadrivalent (2021/2022) |
|
90688 |
VACC AIIV4 NO PRSRV 0.5ML IM |
Seqirus Inc. |
70461-0121-03 |
Fluad Quadrivalent (2021/2022) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0637-15 |
Fluzone Quadrivalent (2022/2023) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Seqirus Inc. |
33332-0422-10 |
Afluria Quadrivalent (2022/2023) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Sanofi Pasteur, Inc. |
49281-0639-15 |
Fluzone Quadrivalent (2023/2024) |
|
90688 |
IIV4 VACCINE SPLT 0.5 ML IM |
Seqirus Inc. |
33332-0423-10 |
Afluria Quadrivalent (2023/2024) |
|
90694 |
VACC AIIV4 NO PRSRV 0.5ML IM |
Seqirus Inc. |
70461-0120-03 |
Fluad Quadrivalent (2020/2021) |
|
90694 |
VACC AIIV4 NO PRSRV 0.5ML IM |
Seqirus Inc. |
70461-0120-03 |
Fluad Quadrivalent (2020/2021) |
|
90694 |
VACC AIIV4 NO PRSRV 0.5ML IM |
Seqirus Inc. |
70461-0122-03 |
Fluad Quadrivalent (2022/2023) (Pres Free) |
|
90694 |
VACC AIIV4 NO PRSRV 0.5ML IM |
Seqirus Inc. |
70461-0123-03 |
Fluad Quadrivalent (2023/2024) (Pres Free) |
|
90732 |
PPSV23 VACC 2 YRS+ SUBQ/IM |
Merck |
00006-4739-00 |
Pneumovax 23 |
|
90732 |
PPSV23 VACC 2 YRS+ SUBQ/IM |
Merck |
00006-4837-02 |
Pneumovax 23 |
|
90732 |
PPSV23 VACC 2 YRS+ SUBQ/IM |
Merck |
00006-4837-03 |
Pneumovax 23 |
|
90732 |
PPSV23 VACC 2 YRS+ SUBQ/IM |
Merck |
00006-4943-00 |
Pneumovax 23 |
|
90739 |
HEPB VACC 2 DOSE ADULT IM |
Dynavax Technologies |
43528-0002-05 |
Heplisav-B |
|
90739 |
HEPB VACC 2 DOSE ADULT IM |
Dynavax Technologies |
43528-0003-05 |
Heplisav-B |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
Merck |
00006-4992-00 |
Recombivax Hb |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
A-S Medication Solutions, LLC |
50090-1223-00 |
ENGERIX-B |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
A-S Medication Solutions, LLC |
50090-1223-01 |
ENGERIX-B |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-11 |
ENGERIX-B |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-34 |
ENGERIX-B |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-43 |
ENGERIX-B |
|
90740 |
HEPB VACC 3 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-52 |
ENGERIX-B |
|
90743 |
HEPB VACC 2 DOSE ADOLESC IM |
Merck |
00006-4094-02 |
Recombivax Hb |
|
90743 |
HEPB VACC 2 DOSE ADOLESC IM |
Merck |
00006-4995-00 |
Recombivax Hb |
|
90743 |
HEPB VACC 2 DOSE ADOLESC IM |
Merck |
00006-4995-41 |
Recombivax Hb |
|
90744 |
HEPB VACC 3 DOSE PED/ADOL IM |
Merck |
00006-4094-09 |
Recombivax Hb |
|
90744 |
HEPB VACC 3 DOSE PED/ADOL IM |
Merck |
00006-4981-00 |
Recombivax Hb |
|
90744 |
HEPB VACC 3 DOSE PED/ADOL IM |
Merck |
00006-4995-41 |
Recombivax Hb |
|
90744 |
HEPB VACC 3 DOSE PED/ADOL IM |
A-S Medication Solutions, LLC |
50090-1706-00 |
ENGERIX-B PEDIATRIC |
|
90744 |
HEPB VACC 3 DOSE PED/ADOL IM |
GlaxoSmithKline |
58160-0820-11 |
ENGERIX-B PEDIATRIC |
|
90744 |
HEPB VACC 3 DOSE PED/ADOL IM |
GlaxoSmithKline |
58160-0820-52 |
ENGERIX-B PEDIATRIC |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
Merck |
00006-4094-02 |
Recombivax Hb |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
Merck |
00006-4094-09 |
Recombivax Hb |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
Merck |
00006-4995-00 |
Recombivax Hb |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
Merck |
00006-4995-41 |
Recombivax Hb |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
A-S Medication Solutions, LLC |
50090-1223-00 |
ENGERIX-B |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
A-S Medication Solutions, LLC |
50090-1223-01 |
ENGERIX-B |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
GlaxoSmithKline |
58160-0821-11 |
ENGERIX-B |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
GlaxoSmithKline |
58160-0821-34 |
ENGERIX-B |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
GlaxoSmithKline |
58160-0821-43 |
ENGERIX-B |
|
90746 |
HEPB VACCINE 3 DOSE ADULT IM |
GlaxoSmithKline |
58160-0821-43 |
ENGERIX-B |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
Merck |
00006-4992-00 |
Recombivax Hb |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
A-S Medication Solutions, LLC |
50090-1223-00 |
ENGERIX-B |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
A-S Medication Solutions, LLC |
50090-1223-01 |
ENGERIX-B |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-11 |
ENGERIX-B |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-34 |
ENGERIX-B |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-43 |
ENGERIX-B |
|
90747 |
HEPB VACC 4 DOSE IMMUNSUP IM |
GlaxoSmithKline |
58160-0821-52 |
ENGERIX-B |
|
90756 |
CCIIV4 VACC ABX FREE IM |
Seqirus Inc. |
70461-0419-10 |
Flucelvax Quadrivalent (2019/2020) |
|
90756 |
CCIIV4 VACC ABX FREE IM |
Seqirus Inc. |
70461-0420-10 |
Flucelvax Quadrivalent (2020/2021) |
|
90756 |
CCIIV4 VACC ABX FREE IM |
Seqirus Inc. |
70461-0421-10 |
Flucelvax Quadrivalent (2021/2022) |
|
90756 |
CCIIV4 VACC ABX FREE IM |
Seqirus Inc. |
70461-0422-10 |
Flucelvax Quadrivalent (2022/2023) |
|
90756 |
CCIIV4 VACC ABX FREE IM |
Seqirus Inc. |
70461-0423-10 |
Flucelvax Quadrivalent (2023/2024) |
|
90759 |
HEPB VAC 3AG 10MCG 3 DOS IM |
VBI Vaccines |
75052-0001-10 |
PREHEVBRIO |
|
91318 |
SARSCOV2 VAC 3MCG TRS-SUC IM |
Pfizer |
59267-4315-02 |
COVID-19 Vaccine 2023/2024 |
|
91319 |
SARSCV2 VAC 10MCG TRS-SUC IM |
Pfizer |
59267-4331-02 |
COVID-19 Vaccine 2023/2024 |
|
91320 |
SARSCV2 VAC 30MCG TRS-SUC IM |
Pfizer |
00069-2362-10 |
COMIRNATY 2023/2024 |
|
91320 |
SARSCV2 VAC 30MCG TRS-SUC IM |
Pfizer |
00069-2392-10 |
COMIRNATY 2023/2024 |
|
91321 |
SARSCOV2 VAC 25 MCG/.25ML IM |
Moderna |
80777-0287-92 |
COVID-19 Vaccine 2023/2024 |
|
91322 |
SARSCOV2 VAC 50 MCG/0.5ML IM |
Moderna |
80777-0102-96 |
SPIKEVAX 2023/2024 |
|
91322 |
SARSCOV2 VAC 50 MCG/0.5ML IM |
Moderna |
80777-0102-93 |
SPIKEVAX 2023/2024 |
Disclaimer: The above list may not be all-inclusive. Please be sure you are providing vaccines appropriate for the current 2023/2024 flu season.
Pneumococcal Vaccine National Fees
The fees provided below are subject to change with each quarterly drug update. For current fees, please check the CMS website Vaccine Pricing page.
|
CPT® |
Description |
1/01/24 |
04/01/24 |
07/01/24 |
10/01/24 |
|---|---|---|---|---|---|
|
90670 |
Pneumococcal vacc, 13 val im |
$257.99 |
$257.99 |
$257.99 |
|
|
90671 |
Pneumococcal Conj vacc, 15 val |
$253.56 |
$253.56 |
$253.56 |
|
|
90677 |
Pneumococcal Conj vacc, 20 val |
$288.66 |
$298.04 |
$298.04 |
|
|
90732 |
Pneumococcal vaccine |
$133.47 |
$133.47 |
$133.47 |
|
Resources
- CR 13560 July 2024 Quarterly Average Sales Price [ASP] Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- CR 13492 (PDF) — April 2024 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- CR 13380 (PDF) — January 2024 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- CR 13317 (PDF) — Influenza Vaccine Payment Allowances Annual Update for 2023/2024 Season
- CR 12439 (PDF) — Claims Processing Instructions for the New Pneumococcal 15-valent Conjugate Vaccine Code 90671 and Pneumococcal 20-valent Conjugate Vaccine Code 90677
- Seasonal Influenza Vaccines Pricing
- Vaccine Pricing