Flu Shot
Get payment allowances & effective dates for the 2024–2025 season.
This content is for health care providers. If you're a person with Medicare, learn more about flu shots.
Frequency & Coverage
- The CDC recommends annual flu shots for everyone 6 months and older each flu season. September and October are the best times for most people to get vaccinated.
- Medicare Part B covers the seasonal flu shot.
- We cover additional flu shots if medically necessary. Patients can get flu shots twice in a calendar year during 2 different flu seasons, and we’ll pay for both shots.
- Your patients pay nothing if you accept assignment. There’s no copayment, coinsurance, or deductible.
- Find out when your patients are eligible for the flu shot (PDF). We give information for dates of service in the last 18 months:
- CPT or HCPCS codes
- Dates of service
- NPIs who administered the shots
If you need help, contact your eligibility service provider.
Billing
- All providers who administer the flu shot must accept assignment.
- You may use roster billing or submit an individual claim. Learn more about roster billing, mass immunizers, and centralized billing.
- Entities, like local health facilities, must get an NPI (PDF) if they’ve never submitted Medicare claims.
- Starting on January 1, 2024, you may bill for an additional payment for administering the flu vaccine to Medicare patients in their homes under certain circumstances. Learn more about the In-Home Vaccine Administration: Additional Payment.
- Skilled nursing facility enforcement discretion for pharmacy billing ended on June 30, 2023. You can bill for flu shot administration and vaccine products with dates of service from September 20, 2021 – June 30, 2023.
ICD-10, HCPCS, and CPT codes
ICD-10 Code: Z23
- HCPCS & CPT Codes
Administration & Diagnosis Codes Vaccine Codes & Descriptors 90630 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use 90653 Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use 90654 Influenza virus vaccine, trivalent (IIV3), split virus, preservative-free, for intradermal use 90655 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use 90657 Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use 90658 Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use 90660 Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use 90672 Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use 90673 Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use 90674 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use 90682 Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use 90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use 90687 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use 90688 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use 90689 Influenza virus vaccine quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25mL dosage, for intramuscular use 90694 Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use 90756 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use Q2034 Influenza virus vaccine, split virus, for intramuscular use (agriflu) Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) Q2036 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) Q2039 Influenza virus vaccine, not otherwise specified G0008 Administration of influenza virus vaccine
Additional Resources
- Flu Shot & Administration
- Preventive Services webpage
- CDC Flu webpage
- Office of Minority Health Immunization and Vaccine Resources webpage
- Annual Influenza Vaccination (PDF) data snapshot: Learn about disparities in Medicare patients
- Manuals: