Influenza Virus Vaccine and Administration - JE Part A

HCPCS/CPT Codes

• 90653, 90656, 90657, 90658, 90660, 90661, 90662, 90673 – Influenza Virus Vaccine (effective 8/01/2025 - 07/31/2026)
• G0008 - Administration of influenza virus vaccine
• M0201 - Additional administration of influenza vaccine inside patient's home; reported only once per date of service

Frequency

Once per influenza season (additional flu shots are covered if medically necessary)

Diagnosis Code

Z23 - Encounter for immunization

Coverage

All Medicare beneficiaries

Payment

Copayment/coinsurance waived; Deductible waived

Roster Billing

• Simplifies claims by allowing mass immunizers to submit one claim form with a list of several immunized beneficiaries on the same date
• Use Medicare Beneficiary Identifiers (MBIs) to check eligibility and submit claims

Noridian Medicare Portal

No

Resources

• Influenza and Pneumonia Billing (Links to Jurisdiction E Part B webpage)
• CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 50.4.4.2
• CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 10
• CMS Medicare Preventive Services
• CMS Roster Billing for Mass Immunizers
• CMS Vaccine Pricing