Flu vaccine coverage includes fee bonus for in-home administration

by Richard Scott on Jan 21, 2024
As flu season continues, stay up to date on the current national, non-facility pricing of influenza vaccines. The table below conveys 2023-2024 payment allowances on oft-reported vaccines, along with coding details. Also, don't forget to add an M code when performing in-home vaccinations
 
Pricing limits range from a low of $10.44 to a high of $77.36 per product.
 
Remember that, as of Jan. 1, 2024, CMS is upping the payment amount for select vaccine administered in a patient's residence. You'll gain an additional $38 per vaccine administration performed in a patient's home, more than doubling the typical administration payment of $30 (total about $68). 
 
If you are administering vaccines in the home, you'll need to report two codes to realize the extra payment. First, you'll stick with the normal administration code for the flu (G0008), hepatitis B (G0010) or pneumococcal (G0009) vaccine. Then, also report HCPCS Level II code M0201 on the claim to signal the in-home administration.
 
2023-2024 flu season vaccine pricing
Code Manufacturer Vaccine name Payment allowance Effective dates
90662 Sanofi Pasteur Fluzone High-Dose Quadrivalent (2023/2024)
$73.403
08/01/2023 – 07/31/2024
90672 MedImmune FluMist Quadrivalent (2023/2024)
$27.788
08/01/2023 – 07/31/2024
90674 Seqirus Flucelvax Quadrivalent (2023/2024) (Preservative Free)
$34.172
08/01/2023 – 07/31/2024
90682 Sanofi Pasteur Flublok Quadrivalent (2023/2024) (Preservative Free)
$73.403
08/01/2023 – 07/31/2024
90686 GlaxoSmithKline
Fluarix Quadrivalent (2023/2024) (Preservative free)
Flulaval Quadrivalent (2023/2024) (Preservative Free)
$22.350
08/01/2023 – 07/31/2024
Sanofi Pasteur Fluzone Quadrivalent (2023/2024) (Preservative Free)
Seqirus Afluria Quadrivalent (2023/2024) (Preservative Free)
90687 Sanofi Pasteur Fluzone Quadrivalent 0.25ml (2023/2024)
$10.439
08/01/2023 – 07/31/2024
Seqirus Afluria Quadrivalent 0.25ml (2023/2024)
90688 Sanofi Pasteur Fluzone Quadrivalent (2023/2024)
$20.878
08/01/2023 – 07/31/2024
Seqirus Afluria Quadrivalent (2023/2024)
90694 Seqirus Fluad Quadrivalent (2023/2024) (Preservative Free)
$77.359
08/01/2023 – 07/31/2024
90756 Seqirus Flucelvax Quadrivalent (2023/2024)
$32.374
08/01/2023 – 07/31/2024
Source: CMS Vaccine Pricing, 2023-2024
 
 
 
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