90682 (RIV4) Influenza, Quad, recombinant 46.00 46.31 (Not Currently on Medicaid – DNA, protein only, preserv. & Preventive Fee Schedule) antibiotic free 90685* - (IIV4) Influenza, Quad, preservative 23.00 21.20 18.40 free; 0.25 mL dosage 90686* - (IIV4) Influenza, Quad, preservative 19.00 19.03 18.40 free; 0.5 mL dosage 90687* - (IIV4) Influenza, Quad, 0.25 mL 17.00 9.40 18.40 dosage 90688* - (IIV4) Influenza, Quad, 0.5 mL 17.00 17.84 18.40 dosage 90756 (CcIIV4) Influenza, Quad, 5.0 mL 22.79 22.79 (Not Currently on Medicaid – dosage Preventive Fee Schedule) Below MEDICARE codes (formerly 90658 code) Q2035 5.0 ml Afluria- Influenza, 17.69 9yrs & ↑ Q2037 5.0ml Fluvirin-Influenza, 17.69 4yrs & ↑ Q2039 Influenza vaccine, NOS 22.79 INFLUENZA (FLU) Administration Codes CPT Code (non-VFC) Description Rate (self pay) Medicare Preventive Medicaid (501 ServiceFile) (912 Service File) G0008 Flu Administration (Slide) 18.00 25.51 Medicare (FFC) 19.00 ≥19yrs <19yrs Not VFC and Not by Component) (by injection) Flu Administration (19yrs & older) (Slide) 19.93 25.51 or (VFC and Not by Component) 90473 (intranasal) Not VFC and by route (FFC) 19.00 90460 Flu Administration (6mos. - <19yrs) VFC (Slide) 19.93 (by Component) and by Component at 19.93) and Not VFC by Component (FFC at 19.00)
90682 – (RIV4) Influenza, Quad, recombinant DNA, protein only, preserv. & antibiotic free 46.00 46.31 (Not Currently on Medicaid Preventive Fee Schedule) 90685* - (IIV4) Influenza, Quad, preservative free; 0.25 mL dosage 23.00 21.20 18.40 90686* - (IIV4) Influenza, Quad, preservative free; 0.5 mL dosage 19.00 19.03 18.40 90687* - (IIV4) Influenza, Quad, 0.25 mL dosage 17.00 9.40 18.40 90688* - (IIV4) Influenza, Quad, 0.5 mL dosage 17.00 17.84 18.40 90756 – (CcIIV4) Influenza, Quad, 5.0 mL dosage 22.79 22.79 (Not Currently on Medicaid Preventive Fee Schedule) Below MEDICARE codes (formerly 90658 code) Q2035 5.0 ml Afluria- Influenza, 9yrs & ↑ 17.69 Q2037 5.0ml Fluvirin-Influenza, 4yrs & ↑ 17.69 Q2039 Influenza vaccine, NOS 22.79 INFLUENZA (FLU) Administration Codes CPT Code (non-VFC) Description Rate (self pay) (501 ServiceFile) Medicare Preventive Medicaid (912 Service File) G0008 Flu Administration Medicare ≥19yrs <19yrs Not VFC and Not by Component) (Slide) 18.00 (FFC) 19.00 25.51 (by injection) or 90473 (intranasal) Flu Administration (19yrs & older) (VFC and Not by Component) Not VFC and by route (Slide) 19.93 (FFC) 19.00 25.51 90460 (by Component) Flu Administration (6mos. - <19yrs) VFC and by Component Not VFC and by Component (Slide) 19.93 at 19.93) (FFC at 19.00)