Fee Schedule for Flu Vaccine

CPT 90630 Payment allowance is $23.467. Effective dates: 8/1/2015-7/31/2016
CPT 90654 Payment allowance is pending. Effective dates: 8/1/2015-7/31/2016
CPT 90655 Payment allowance is pending. Effective dates: 8/1/2015-7/31/2016
CPT 90656 Payment allowance is $13.880. Effective dates: 8/1/2015-7/31/2016
CPT 90657 Payment allowance is $6.022. Effective dates: 8/1/2015-7/31/2016
CPT 90661 Payment allowance is $22.288. Effective dates: 8/1/2015-7/31/2016
CPT 90662 Payment allowance is $36.315. Effective dates: 8/1/2015-7/31/2016
CPT 90672 Payment allowance is pending. Effective dates: 8/1/2015-7/31/2016
CPT 90673 Payment allowance is $37.193 Effective dates: 9/26/2015-7/31/2016
CPT 90685 Payment allowance is $24.596. Effective dates: 8/1/2015-7/31/2016
CPT 90686 Payment allowance is $18.155. Effective dates: 8/1/2015-7/31/2016
CPT 90687 Payment allowance is $9.134. Effective dates: 8/1/2015-7/31/2016
CPT 90688 Payment allowance is $18.269. Effective dates: 8/1/2015-7/31/2016
HCPCS Q2035 Payment allowance is $13.025. Effective dates: 8/1/2015-7/31/2016
HCPCS Q2036 Payment allowance is pending. Effective dates: 8/1/2015-7/31/2016
HCPCS Q2037 Payment allowance is $15.830. Effective dates: 8/1/2015-7/31/2016
HCPCS Q2038 Payment allowance is $12.044. Effective dates: 8/1/2015-7/31/2016
HCPCS Q2039 Flu Vaccine Adult – Not Otherwise Classified payment allowance is to be determined by the local claims processing contractor with effective dates of 8/1/2015-7/31/2016.

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