Forget about digging through the latest Medicare Physician Fee Schedule and calculating the conversion factor when it comes to determining your Part B reimbursement rate for flu shots. CMS has come out with a handy MLN Matters article explaining this information. According to MLN Matters article MM7120, released on Oct. 22, the Part B payment allowance for flu immunizations is as follows:
- 90655 (Influenza virus vaccine, split virus, preservative free, when administered to children 6 to 35 months of age, for intramuscular use): $12.398.
- 90656 (Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use): $12.375.
- 90657 (Influenza virus vaccine, split virus, when administered to children 6 to 35 months of age, for intramuscular use): $6.297.
- 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) for dates of service Sept. 1, 2010 through Dec. 31, 2010: $11.368.
If your MAC reimburses for either 90660 (FluMist) or 90662 (Fluzone High-Dose), the Part B payment amount effective Sept. 1 for 90660 is $22.316, and for 90662 is $29.213. Carriers differ on whether they will cover these types of influenza immunizations.
Annual Part B deductible and coinsurance amounts do not apply to these charges, the article notes.
