Use This Medicare Guide for Vaccine Coding

The 2013-14 flu season (October-May) is upon us. Don’t forget that Medicare covers the seasonal flu vaccine without any out-of-pocket costs for Medicare patients. No deductible or copayment/coinsurance applies. Medicare offers these reminders:

  • Take advantage of each office visit as an opportunity to encourage your patients to protect themselves from the seasonal flu and serious complications by getting a seasonal flu shot.
  • Continue to provide the seasonal flu shot as long as you have vaccine available, even after the new year.
  • Be sure to immunize yourself and your staff so you don’t risk spreading the highly contagious flu virus to your patients.
  • Be sure to bill both codes for both the actual vaccine and the appropriate vaccine administration code.   

Here are resources for your practice:

  • Quick Reference Information (PDF) is a handy Medicare immunization coding and billing guide (seasonal influenza virus, pneumococcal, and hepatitis B) with FAQs.
  • MLN Matters  No. MM8433(PDF) from the Centers for Medicare & Medicaid Services lists current payment allowances.
  • TMA’s Influenza Season 2012-13 webpage has additional information and resources, including:

To order copies of the poster to hang in your office or break room, or copies of the handout in English or Spanish, contact TMA’s outreach coordinator, Tammy Wishard, at or (512) 370-1470.

  • The Immunization Action Coalition’s (IAC’s) free flu pocket guide for health care professionals contains vaccination dosing information, including new recommendations for children, and talking points. It is one of several free pocket guides are available from IAC to help you educate patients about vaccine-preventable diseases.

 Revised Sept. 26, 2013

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