Seasonal Influenza Vaccines Pricing

CPT 90630 Payment allowance is $20.343. Effective dates: 8/1/2017-7/31/2018

CPT 90653 Payment allowance is $50.217. Effective dates: 8/1/2017-7/31/2018

CPT 90656 Payment allowance is $19.247. Effective dates: 8/1/2017-7/31/2018

CPT 90662 Payment allowance is $49.025. Effective dates: 8/1/2017-7/31/2018

CPT 90673 Payment allowance is $40.613. Effective dates: 8/1/2017-7/31/2018

CPT 90674 Payment allowance is $24.047. Effective dates: 8/1/2017-7/31/2018

CPT 90682 Payment allowance is $46.313. Effective dates: 8/1/2017-7/31/2018 (New code)

CPT 90685 Payment allowance is $21.198. Effective dates: 8/1/2017-7/31/2018

CPT 90686 Payment allowance is $19.032. Effective dates: 8/1/2017-7/31/2018

CPT 90687 Payment allowance is $9.403.  Effective dates: 8/1/2017-7/31/2018

CPT 90688 Payment allowance is $17.835. Effective dates: 8/1/2017-7/31/2018

CPT 90756 Payment allowance is $22.793. Effective dates: 1/1/2018-7/31/2018  (Note: Providers and Medicare Administrative Contractors shall use HCPCS Q2039 for dates of service from 8/1/2017 – 12/31/2017. See special note under HCPCS Q2039 for payment amounts for this product prior to 1/1/2018.)

HCPCS Q2035 Payment allowance is $17.685. Effective dates: 8/1/2017-7/31/2018

HCPCS Q2037 Payment allowance is $17.685. Effective dates: 8/1/2017-7/31/2018

HCPCS Q2039 Flu Vaccine Adult – Not Otherwise Classified payment allowance is to be determined by the local claims processing contractor with effective dates of 8/1/2017-7/31/2018.

Special note: Until CPT code 90756 is implemented on 1/1/2018; Q2039 shall be used for products described by the following language: influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5mL dosage, for intramuscular use. The payment allowance for these products, effective for dates of service 8/1/2017 – 12/31/2017 is $22.793.

For more information refer: MM10224

See also: Payment Allowances and Effective Dates for the 2016-2017 Flu Season