The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), except when the vaccine is given in a hospital outpatient department, rural health clinic (RHC) or federally qualified health center (FQHC). Payment is based on reasonable cost for these 3 places.

Annual Part B deductible and coinsurance amounts do not apply for flu shots. All physicians, non-physician practitioners and suppliers who administer the shot must take assignment on the claim for the shot.

The 2021-2022 season starts on August 1, 2021 and ends on July 31, 2022. Unless otherwise specified, your Medicare Administrative Contractors (MACs) will decide the Medicare Part B payment allowance for HCPCS code Q2039 that you provide on these dates of service.

Source: U.S. Centers for Medicare & Medicaid Services (CMS)

 

About 3Gen

3Gen Consulting has always been in the forefront when it comes to adding value. We always believe in setting our own standards. What sets us apart is the investment that we make in our people, processes and innovation to provide you with market leading healthcare revenue cycle management services. We work as an extension of our clients’ teams by focusing on their key challenges, aligning with their culture and delivering the best results.

If you’re interested in finding the right medical billing and coding services partner, contact us today.

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