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)
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