Flu vaccine coverage includes fee bonus for in-home administration

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.