The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), as reflected in the published compendia.
In hospital outpatient departments, payment is based on reasonable cost.
Annual Part B deductible and coinsurance amounts don’t apply for the influenza virus vaccinations. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must take assignment on the claim for the vaccine.
Annual Influenza Vaccine season starts on August 1 and ends on July 31 of the following year.
Payment Allowances and Effective Dates by Flu Season
