CMS Issues Influenza Vaccine Annual Payment Updates.
The Centers for Medicare & Medicaid (CMS) updated the influenza vaccine annual payment limits for the 2013-2014 season. Change Request (CR) 8433 updates payment allowances effective August 1, 2013 when payment for seasonal influenza vaccines is based on 95 percent of the Average Wholesale Price. The updated payment limits exclude seasonal influenza vaccines furnished in a hospital outpatient department, a Rural Health Clinic, or a Federally Qualified Health Center for which payment is based on reasonable costs. CR 8433 provides payment allowances for the following seasonal influenza vaccine codes:
• Current Procedural Terminology (CPT) codes 90654, 90655, 90656, 90657, 90660, 90661, 90662, 90672, 90673, 90685, 90686, 90687, and 90688; and
• Healthcare Common Procedure Coding System (HCPCS) codes Q2033, Q2035, Q2036, Q2037, and Q2038.
HCPCS Q2039 (Flu Vaccine Adult – Not Otherwise Classified) payment allowance is to be determined by the local claims processing contractor. Payment limits for influenza vaccines that are approved after the release of CR 8433 will be posted on the CMS Seasonal Influenza Vaccines Pricing webpage at:
The CMS transmittal regarding the annual influenza vaccine payment update is available at:
http://cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2786CP.pdf
The MLN Matters article regarding the annual influenza vaccine payment update is available at:
The Centers for Medicare & Medicaid Services. “Influenza Vaccine Payment Allowances – Annual Update for the 2013-2014 Season.” Transmittal 2786. 13 Sept. 2013.
The Centers for Medicare & Medicaid Services. “Influenza Vaccine Payment Allowances – Annual Update for the 2013-2014 Season.” MLN Matters Article: MM8433. 13 Sep. 2013.
