Seasonal Influenza Vaccines Pricing
Guidance for payment allowances and effective dates for influenza vaccines.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 26, 2020
The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), as reflected in the published compendia.
In hospital outpatient departments, payment is based on reasonable cost.
Annual Part B deductible and coinsurance amounts don’t apply for the influenza virus vaccinations. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must take assignment on the claim for the vaccine.
Annual Influenza Vaccine season starts on August 1 and ends on July 31 of the following year.
Payment Allowances and Effective Dates by Flu Season
2022-2023
Payment Allowances and Effective Dates for the 2022-2023 Flu Season:
Code Labeler Name Vaccine Name Payment Allowance Effective Dates 90662 Sanofi Pasteur Fluzone High-Dose Quadrivalent (2022/2023) $ 69.941 08/01/2022 – 07/31/2023 90672 MedImmune FluMist Quadrivalent (2022/2023) $ 26.876 08/01/2022 – 07/31/2023 90674 Seqirus Flucelvax Quadrivalent (2022/2023) (Preservative Free) $ 32.278 08/01/2022 – 07/31/2023 90682 Sanofi Pasteur Flublok Quadrivalent (2022/2023) (Preservative Free) $ 69.941 08/01/2022 – 07/31/2023 90686 GlaxoSmithKline
Sanofi Pasteur
Seqirus
Fluarix Quadrivalent (2022/2023) (Preservative Free)
Flulaval Quadrivalent (2022/2023) (Preservative Free)
Fluzone Quadrivalent (2022/2023) (Preservative Free)
Afluria Quadrivalent (2022/2023) (Preservative Free)$ 21.518 08/01/2022 – 07/31/2023 90687 Sanofi Pasteur
Seqirus
Fluzone Quadrivalent 0.25ml (2022/2023)
Afluria Quadrivalent 0.25ml (2022/2023)$ 10.241 08/01/2022 – 07/31/2023 90688 Sanofi Pasteur
Seqirus
Fluzone Quadrivalent (2022/2023)
Afluria Quadrivalent (2022/2023)$ 20.482 08/01/2022 – 07/31/2023 90694 Seqirus Fluad Quadrivalent (2022/2023) (Preservative Free) $ 71.682 08/01/2022 – 07/31/2023 90756 Seqirus Flucelvax Quadrivalent (2022/2023) $ 30.581 08/01/2022 – 07/31/2023 Payment limits and effective dates for newly approved and marketed influenza vaccines will be posted to this webpage.
2021 - 2022
Payment Allowances and Effective Dates for the 2021-2022 Flu Season:
Code
Labeler Name
Vaccine Name
Payment Allowance
Effective Dates
90662
Sanofi Pasteur
Fluzone High-Dose Quadrivalent (2021/2022)
$65.261
08/01/2021 – 07/31/2022
90672
MedImmune
FluMist Quadrivalent (2021/2022)
$26.876
08/26/2021 – 07/31/2022
90674
Seqirus
Flucelvax Quadrivalent (2021/2022) (Pres Free)
$29.940
08/11/2021 – 07/31/2022
90682
Sanofi Pasteur
Flublok Quadrivalent (2021/2022)
$65.261
08/01/2021 – 07/31/2022
90685
Sanofi Pasteur
Seqirus
Fluzone Quadrivalent 0.25ml (2021/2022) (Pres Free)
Afluria Quadrivalent 0.25ml (2021/2022) (Pres Free)
$21.639
08/01/2021 – 07/31/2022
90686
GlaxoSmithKline
Sanofi Pasteur
Seqirus
Fluarix Quadrivalent (2021/2022) (Pres free)
Flulaval Quadrivalent (2021/2022) (Pres Free)
Fluzone Quadrivalent (2021/2022) (Pres Free)
Afluria Quadrivalent (2021/2022) (Pres Free)
$20.526
08/01/2021 – 07/31/2022
90687
Sanofi Pasteur
Seqirus
Fluzone Quadrivalent 0.25ml (2021/2022)
Afluria Quadrivalent 0.25ml (2021/2022)
$9.953
08/01/2021 – 07/31/2022
90688
Sanofi Pasteur
Seqirus
Fluzone Quadrivalent (2021/2022)
Afluria Quadrivalent (2021/2022)
$19.906
08/01/2021 – 07/31/2022
90694
Seqirus
Fluad Quadrivalent (2021/2022)
$66.426
08/11/2021 – 07/31/2022
90756
Seqirus
Flucelvax Quadrivalent (2021/2022)
$28.370
08/11/2021 – 07/31/2022
Payment limits and effective dates for newly approved and marketed influenza vaccines will be posted to this webpage.
2020 - 2021
Payment Allowances and Effective Dates for the 2020-2021 Flu Season:
Code
Labeler Name
Vaccine Name
Payment Allowance
Effective Dates
90653
Seqirus
Fluad (2020/2021)
$59.529
8/01/2020 – 07/31/2021 90694
Seqirus
Fluad Quadrivalent (2020/2021)
$61.000
8/01/2020 – 07/31/2021 90662
Sanofi Pasteur
Fluzone High-Dose Quadrivalent (2020/2021)
$ 60.982
8/05/2020 – 07/31/2021 90672
MedImmune
FluMist Quadrivalent (2020/2021)
$26.876
8/12/2020 – 07/31/2021 90674
Seqirus
Flucelvax Quadrivalent (2020/2021) (Pres Free)
$29.228
8/06/2020 – 07/31/2021 90682
Sanofi Pasteur
Flublok Quadrivalent (2020/2021)
$60.982
8/01/2020 – 07/31/2021
90685
Sanofi Pasteur
Seqirus
Fluzone Quadrivalent 0.25ml (2020/2021) (Pres Free)
Afluria Quadrivalent 0.25ml (2020/2021) (Pres Free)
$21.129
8/01/2020 – 07/31/2021
90686
GlaxoSmithKline
Sanofi Pasteur
Seqirus
Fluarix Quadrivalent (2020/2021) (Pres free)
Flulaval Quadrivalent (2020/2021) (Pres Free)
Fluzone Quadrivalent (2020/2021) (Pres Free)
Afluria Quadrivalent (2020/2021) (Pres Free)
$19.581
08/01/2020 – 07/31/2021
90687
Sanofi Pasteur
Seqirus
Fluzone Quadrivalent 0.25ml (2020/2021)
Afluria Quadrivalent 0.25ml (2020/2021)
$9.584
8/01/2020 – 07/31/2021
90688
Sanofi Pasteur
Seqirus
Fluzone Quadrivalent (2020/2021)
Afluria Quadrivalent (2020/2021)
$19.168
8/01/2020 – 07/31/2021
90756
Seqirus
Flucelvax Quadrivalent (2020/2021)
$27.695
8/06/2020 – 07/31/2021 Payment limits and effective dates for newly approved and marketed influenza vaccines will be posted to this webpage.
During the flu season, if the FDA approves new vaccines, we’ll update our pricing table.
Get more information on frequency & coverage, coding, and billing.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.