INFLUENZA (FLU) Vaccine Codes CPT Code Description Rate (self pay) Medicare Preventive Medicaid (*non-KVP will require (501 Service As of: 07/01/18 9/30/2018 (912 Service File) – a NV modifier) File) AND/OR INSURANCE Medicare has Not up-dated Fee Schedule for 2018-2019 Flu Year. Influenza, Quad preservative 90630*- (IIV4) 20.00 20.34 (Not Currently on Medicaid (Not VFC Covered) free, Intradermal Preventive Fee Schedule) 90653 (aIIV3) Influenza vaccine, inactivated 50.00 50.22 (Not Currently on Medicaid – (IIV), subunit, adjuvanted Preventive Fee Schedule) 90656* - (IIV3) Influenza, 0.5 mL dosage, 16.00 19.25 18.40 preservative free (Slide and FFC) Influenza, 0.25 mL dosage 90657* - (IIV3) 12.00 0.00 18.40 (Slide and FFC) 90658* - (IIV3) Influenza, 0.5 mL dosage 15.00 Medicare See`Q’ 18.40 – (Slide and FFC) Insurance - 15.00 90661* - (ccIIV3) Influenza, trivalent, preserv. & 20.00 0.00 18.40 antibiotic free, 0.5 mL dosage 90662*-(IIV) Influenza, preserv. free, 49.00 49.03 18.40 high dose, enhanced (Slide and FFC) 90672NV-* VFC Program is not Influenza, live, intranasal, 23.00 26.88 18.40 purchasing FluMist during the FluMist, 2yrs-49yrs (Slide and FFC) 2018-19 influenza season. 90673* - (RIV3) Recombinant DNA Influenza 40.00 40.61 18.40 90674* - (ccIIV4) Influenza, Quad, preserv. & 24.00 24.05 (Not Currently on Medicaid antibiotic free, 0.5 mL dosage Preventive Fee Schedule)
INFLUENZA (FLU) Vaccine Codes CPT Code (*non-KVP will require a NV modifier) Description Rate (self pay) (501 Service File) Medicare As of: 07/01/18 – 9/30/2018 AND/OR INSURANCE Medicare has Not up-dated Fee Schedule for 2018-2019 Flu Year. Preventive Medicaid (912 Service File) 90630*- (IIV4) (Not VFC Covered) Influenza, Quad preservative free, Intradermal 20.00 20.34 (Not Currently on Medicaid Preventive Fee Schedule) 90653 – (aIIV3) Influenza vaccine, inactivated (IIV), subunit, adjuvanted 50.00 50.22 (Not Currently on Medicaid Preventive Fee Schedule) 90656* - (IIV3) Influenza, 0.5 mL dosage, preservative free 16.00 (Slide and FFC) 19.25 18.40 90657* - (IIV3) Influenza, 0.25 mL dosage 12.00 (Slide and FFC) 0.00 18.40 90658* - (IIV3) Influenza, 0.5 mL dosage 15.00 (Slide and FFC) Medicare – See`Q’ Insurance - 15.00 18.40 90661* - (ccIIV3) Influenza, trivalent, preserv. & antibiotic free, 0.5 mL dosage 20.00 0.00 18.40 90662*-(IIV) Influenza, preserv. free, high dose, enhanced 49.00 (Slide and FFC) 49.03 18.40 90672NV-* VFC Program is not purchasing FluMist during the 2018-19 influenza season. Influenza, live, intranasal, FluMist, 2yrs-49yrs 23.00 (Slide and FFC) 26.88 18.40 90673* - (RIV3) Recombinant DNA Influenza 40.00 40.61 18.40 90674* - (ccIIV4) Influenza, Quad, preserv. & antibiotic free, 0.5 mL dosage 24.00 24.05 (Not Currently on Medicaid Preventive Fee Schedule)