CMS monitors the public domain and looks for alerts from CDC for new vaccine products. When a new product enters the market, manufacturers should notify CMS at sec303aspdata@cms.hhs.gov.
Medicare Part B covers the following types of vaccines and their administration:
- Preventive vaccines specified in statute: Examples include the Influenza, COVID-19, Pneumococcal, and Hepatitis B vaccines, which are used to prevent illness
- Vaccines used for treatment: Examples include the Tetanus, Rabies, and Hepatitis A vaccines, which are used as treatment after exposure to an illness
Vaccine | Payment Methodology | Timing | Additional Information |
---|---|---|---|
Influenza | • 95% of the Average Wholesale Price (AWP) • In certain settings, such as in hospital outpatient departments, hospital based Rural Health Clinics (RHC), and Federally Qualified Health Clinics (FQHC), payment is based on reasonable cost. | Payment limits are established annually and are effective from August 1 to July 31 of the following year. | Visit the Seasonal Influenza section below for more information. |
COVID-19 | • 95% of AWP • In certain settings, such as in hospital outpatient departments, hospital based RHCs, and FQHCs, payment is based on reasonable cost. | Payment limits are updated annually. | Visit the COVID-19 section below for more information. |
Pneumococcal | • 95% of AWP • In certain settings, such as in hospital outpatient departments, hospital based RHCs, and FQHCs, payment is based on reasonable cost. | Payment limits updated quarterly. | Refer to the Average Sales Price (ASP) pricing files for current payment limits. |
Hepatitis B | • 95% of AWP • In certain settings, such as in hospital outpatient departments, hospital based RHCs, and FQHCs, payment is based on reasonable cost. | Payment limits updated quarterly. | Refer to the ASP pricing files for current payment limits |
Vaccines Used for Treatment | Generally,106 percent of ASP | Payment limits updated quarterly. | Refer to the ASP pricing files for current payment limits |
Seasonal Influenza Pricing
Part B deductibles and coinsurance don’t apply for flu vaccine products or their administration. With respect to vaccine products, all providers and suppliers must accept assignment on the claim. The annual flu vaccine season is August 1 through July 31 of the following year. Find more information at Frequency & Coverage, Billing and Coding.
- 2024-2025 Flu Season Pricing Resources
Payment limits and effective dates for newly approved and marketed influenza vaccines will be posted to this webpage.
CPT Code or HCPCS code
CPT or HCPCS Short Descriptor
Labeler Name
Vaccine/Procedure Name
National Payment Allowance
Effective Dates
90653
IIV ADJUVANT VACCINE IM
Seqirus
Fluad Trivalent (2024/2025) Preservative Free $83.490
08/01/2024-07/31/2025
90656
IIV3 VACC NO PRSV 0.5 ML IM
Seqirus
Afluria Trivalent (2024/2025) Preservative Free $22.350
08/01/2024-07/31/2025
Sanofi Pasteur
Fluzone Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
GlaxoSmithKline
Fluvarix Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
FluLaval Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
90657
IIV3 VACCINE SPLT 0.25 ML IM
Seqirus
Afluria Trivalent (2024/2025)
Pediatric Dose
$10.929
08/01/2024-07/31/2025
Sanofi Pasteur
Fluzone Trivalent (2024/2025)
Pediatric Dose
08/01/2024-07/31/2025
90658
IIV3 VACCINE SPLT 0.5 ML IM
Seqirus
Afluria Trivalent (2024/2025) $21.858
08/01/2024-07/31/2025
Sanofi Pasteur
Fluzone Trivalent (2024/2025) 08/01/2024-07/31/2025
90660
LAIV3 VACCINE INTRANASAL
MedImmune
FluMist Trivalent (2024/2025) $28.871
08/06/2024-07/31/2025
90661
CCIIV3 VAC ABX FR 0.5 ML IM
Seqirus
Flucelvax Trivalent (2024/2025) Preservative Free $36.849
08/01/2024-07/31/2025
Flucelvax Trivalent (2024/2025) 08/01/2024-07/31/2025
90662
IIV NO PRSV INCREASED AG IM
Sanofi Pasteur
Fluzone High-Dose Trivalent (2024/2025) Preservative Free $83.492
08/01/2024-07/31/2025
90673
RIV3 VACCINE NO PRESERV IM
Sanofi Pasteur
Flublok Trivalent (2024/2025)
Preservative Free
$83.492
08/01/2024-07/31/2025
Q2039
INFLUENZA VIRUS VACCINE, NOT OTHERWISE SPECIFIED
N/A
N/A
N/A
08/01/2024-07/31/2025
G0008
ADMIN OF FLU VACCINE
N/A
Administration of influenza virus vaccine
Please see links below for
Locality-Adjusted Payment Rates
M0201
FLU VACCINE HOME ADMIN
N/A
Administration of influenza vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home Please see links below for
Locality-Adjusted Payment Rates
Payment limits and effective dates for newly approved and marketed influenza vaccines will be posted to this webpage.
2025 Locality-Adjusted Payment Amounts for Administration of Influenza, Pneumonia, Hepatitis B Vaccines & In-Home Additional Payment for Download
2025 Geographically-Adjusted Payment Rates for Influenza, Pneumococcal, Hepatitis B and COVID-19 Vaccine Administration & In-Home Additional Payment (ZIP) [For claims with dates of service 1/1/2025-12/31/2025]
- Archive: Previous Flu Season Resources
- 2023-2024
- Payment Allowances and Effective Dates for the 2023-2024 Flu Season (PDF)
- 2023 Locality-Adjusted Payment Rates for Influenza, Pneumococcal and Hepatitis B Vaccine Administration (ZIP) [For claims with dates of service 1/1/2023-12/31/2023] - Updated 07/14/2023 to reflect locality revisions for Puerto Rico (PR) and the Virgin Islands (VI)
- 2024 Locality-Adjusted Payment Rates for Influenza, Pneumococcal, Hepatitis B Vaccine Administration & In-Home Additional Payment (ZIP) [For claims with dates of service 1/1/2024-12/31/2024]
- 2022-2023
- 2021-2022
- Payment Allowances and Effective Dates for the 2020-2021 Flu Season (PDF)
- Payment Allowances and Effective Dates for the 2019-2020 Flu Season (PDF)
- Payment Allowances and Effective Dates for the 2018-2019 Flu Season (PDF)
- Payment Allowances and Effective Dates for the 2017-2018 Flu Season (PDF)
- 2023-2024
COVID-19 Vaccines & Monoclonal Antibodies
This section provides the payment allowances and other related information for COVID-19 vaccines and certain monoclonal antibody products. View the COVID-19 provider toolkit for more information about Medicare and COVID-19 during and after the PHE.
- 2024-2025 COVID-19 Vaccine Pricing Resources
CY 2025 COVID-19 Vaccines (DOS - Date of Service; TBD - To Be Determined)
CPT Code or HCPCS Code
CPT or HCPCS Short Descriptor Labeler Name Vaccine/Procedure Name National Payment Allowance Effective for Claims with DOS on or after 03/15/2021 Effective Dates for Medicare Payment 90480 ADMN SARSCOV2 VACC 1 DOSE N/A N/A $44.95[2] 09/11/2023 - TBD M0201 Covid-19 vaccine home admin Home vaccine admin Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home $39.90[2] 06/08/2021 - TBD 91304 SARSCOV2 VAC 5MCG/0.5ML IM Novavax Novavax Covid-19 Vaccine, Adjuvanted (Aged 12 years and older) 2024-2025 Formula $ 161.538 08/30/2024 – TBD 91318 SARSCOV2 VAC 3MCG TRS-SUC Pfizer-BioNTech Pfizer-BioNTech COVID-19 Vaccine 2024-2025 Formula (Yellow Cap) $65.550 08/22/2024 - TBD
91319 SARSCV2 VAC 10MCG TRS-SUC IM Pfizer-BioNTech Pfizer-BioNTech COVID-19 Vaccine 2024-2025 Formula (Blue Cap) $87.780 08/22/2024 - TBD 91320 SARSCV2 VAC 30MCG TRS-SUC IM Pfizer-BioNTech COMIRNATY (COVID-19 Vaccine, mRNA) 2024-2025 Formula $155.895 08/22/2024 - TBD 91321 SARSCOV2 VAC 25 MCG/.25ML IM Moderna Moderna COVID-19 Vaccine 2024-2025 Formula $147.060 08/22/2024 - TBD 91322 SARSCOV2 VAC 50 MCG/0.5ML IM Moderna SPIKEVAX 2024-2025 Formula $161.652 08/22/2024 - TBD CY 2024 COVID-19 Vaccines
CPT Code or HCPCS Code
CPT or HCPCS Short Descriptor Labeler Name Vaccine/Procedure Name National Payment Allowance Effective for Claims with DOS on or after 03/15/2021 Effective Dates for Medicare Payment 90480 ADMN SARSCOV2 VACC 1 DOSE N/A N/A $40.000[2] 09/11/2023 - TBD M0201 Covid-19 vaccine home admin Home vaccine admin Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home $35.50[2] 06/08/2021 - TBD 91304 SARSCOV2 VAC 5MCG/0.5ML IM Novavax Novavax Covid-19 Vaccine, Adjuvanted (Aged 12 years and older) 2023-2024 Formula $ 148.200 07/13/2022 – 08/29/2024 91318 SARSCOV2 VAC 3MCG TRS-SUC Pfizer-BioNTech Pfizer-BioNTech COVID-19 Vaccine 2023-2024 Formula (Yellow Cap) $65.550 09/11/2023 - 8/21/2024
91319 SARSCV2 VAC 10MCG TRS-SUC IM Pfizer-BioNTech Pfizer-BioNTech COVID-19 Vaccine 2023-2024 Formula (Blue Cap) $87.780 09/11/2023 - 8/21/2024 91320 SARSCV2 VAC 30MCG TRS-SUC IM Pfizer-BioNTech COMIRNATY (COVID-19 Vaccine, mRNA) 2023-2024 Formula $131.100 09/11/2023 – 8/21/2024 91321 SARSCOV2 VAC 25 MCG/.25ML IM Moderna Moderna COVID-19 Vaccine 2023-2024 Formula $145.920 09/11/2023 – 8/21/2024 91322 SARSCOV2 VAC 50 MCG/0.5ML IM Moderna SPIKEVAX 2023-2024 Formula $145.920 09/11/2023 – 8/21/2024 Geographically Adjusted Payment Rates for 2025
2025 Geographically-Adjusted Payment Rates for COVID-19 Vaccine Administration & In-Home Additional Payment (ZIP) [For claims with dates of service 1/1/2025-12/31/2025]
- COVID-19 Monoclonal Antibody Pricing Resources
Payment Allowances & Effective Dates for COVID-19 Monoclonal Antibodies & Their Administration:
HCPCS Code HCPCS Short Descriptor Labeler Name Vaccine/Procedure Name National Payment Allowance Effective for Claims with DOS on or after 05/6/2021 National Payment Allowance Effective for Claims with DOS through 05/5/2021 Effective Dates Q0220
Note: This product isn’t currently authorized[12]
Tixagev and cilgav, 300mg AstraZeneca Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg $0.010[1] Code not active during this time period 12/08/2021 - TBD Q0221
Note: This product isn’t currently authorized[12]
Tixagev and cilgav, 600mg AstraZeneca Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg $0.010[1] Code not active during this time period 02/24/2022 - TBD M0220
Note: This product isn’t currently authorized[12]
Tixagev and cilgav inj AstraZeneca Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring $150.50[3] Code not active during this time period 12/08/2021 - TBD M0221
Note: This product isn’t currently authorized[12]
Tixagev and cilgav inj hm AstraZeneca Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency
$250.50[3] Code not active during this time period 12/08/2021 - TBD Q0222
Note: This product isn’t currently authorized[11]
Bebtelovimab 175 mg Eli Lilly Injection, bebtelovimab, 175 mg $2394.00[1] [1a] Code not active during this time period 02/11/2022 - TBD M0222
Note: This product isn’t currently authorized[11]
Bebtelovimab injection Eli Lilly Intravenous injection, bebtelovimab, includes injection and post administration monitoring $350.50[3] Code not active during this time period 02/11/2022 - TBD M0223
Note: This product isn’t currently authorized[11]
Bebtelovimab injection home Eli Lilly Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency $550.50[3] Code not active during this time period 02/11/2022 - TBD Q0239 Bamlanivimab-xxxx Eli Lilly Injection, bamlanivimab, 700 mg Code not active during this time period $0.010[1] 11/10/2020 – 04/16/2021[4] M0239 Bamlanivimab-xxxx infusion Eli Lilly Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring Code not active during this time period $309.600[3] 11/10/2020 – 04/16/2021[4] Q0240[6]
Note: This product isn’t currently authorized[9]Casirivi and imdevi 600mg Regeneron Injection, casirivimab and imdevimab, 600 mg $0.010[1] Code not active during this time period 07/30/2021 – TBD M0240[6]
Note: This product isn’t currently authorized[9]Casiri and imdev repeat Regeneron Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses $450.00[3] Code not active during this time period 07/30/2021 – TBD M0241[6]
Note: This product isn’t currently authorized[9]Casiri and imdev repeat hm Regeneron Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence, this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency, subsequent repeat doses $750.00[3] Code not active during this time period 07/30/2021 – TBD Q0243
Note: This product isn’t currently authorized[9]Casirivimab and imdevimab Regeneron Injection, casirivimab and imdevimab, 2400 mg $0.010[1] $0.010[1] 11/21/2020 – TBD M0243
Note: This product isn’t currently authorized[9]Casirivi and imdevi inj Regeneron Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring $450.00[3] $309.600[3] 11/21/2020 – TBD Q0244[5]
Note: This product isn’t currently authorized[9]Casirivi and imdevi 1200 mg Regeneron Injection, casirivimab and imdevimab, 1200 mg $0.010[1] $0.010[1] 06/03/2021 – TBD M0244
Note: This product isn’t currently authorized[9]Casirivi and imdevi inj hm Regeneron Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency $750.00[3] Code not active during this time period 05/06/2021 – TBD Q0245[8]
Note: This product isn’t currently authorizedBamlanivimab and etesevima Eli Lilly Injection, bamlanivimab and etesevimab, 2100 mg $0.010[1] $0.010[1] 02/09/2021 – TBD M0245[8]
Note: This product isn’t currently authorizedBamlan and etesev infusion Eli Lilly intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring $450.00[3] $309.600[3] 02/09/2021 – TBD M0246[8]
Note: This product isn’t currently authorizedBamlan and etesev infus home Eli Lilly Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency $750.00[3] Code not active during this time period 05/06/2021 – TBD Q0247[7]
Note: This product isn’t currently authorized[10]
Sotrovimab GSK Injection, sotrovimab, 500 mg $2394.00 Code not active during this time period 05/26/2021 – TBD M0247
Note: This product isn’t currently authorized[10]
Sotrovimab infusion GSK Intravenous infusion, sotrovimab, includes infusion and post administration monitoring $450.00[3] Code not active during this time period 05/26/2021 – TBD M0248
Note: This product isn’t currently authorized[10]
Sotrovimab inf, home admin GSK Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency $750.00[3] Code not active during this time period 05/26/2021 – TBD Q0249[2] Tocilizumab for COVID-19 Genentech Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, 1 mg $7.569 Code not active during this time period 06/24/2021 - TBA M0249 Adm Tocilizu COVID-19 1st Genentech Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, includes infusion and post administration monitoring, first dose $450.00[3] Code not active during this time period 06/24/2021 - TBA M0250 Adm Tocilizu COVID-19 2nd Genentech Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, includes infusion and post administration monitoring, second dose $450.00[3] Code not active during this time period 06/24/2021 - TBA Q0224 Inj, pemivibart, 4500 mg Invivyd Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to COVID-19 vaccination, 4500 mg $6,583.50 Code not active during this time period 03/22/2024 – TBD M0224 Pemivibart infusion Invivyd Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, includes infusion and post administration monitoring $450.00[3] Code not active during this time period 03/22/2024 – TBD [1] Providers shouldn't bill for the product if they got it for free through the USG-purchased inventory.
[1a] Payment rate effective for dates of service on or after August 15, 2022. Providers should only bill Medicare for commercially purchased products.
[2] Given the limited clinical situations allowed under the EUA, providers should only bill for tocilizumab on a 12x type of bill (TOB).
[3] We’ll geographically adjust these rates for many providers. We’ve included files with the geographically adjusted payment rates for monoclonal antibody administration in the “Additional Resources” section below. Certain settings use other payment methodologies, such as payment based on reasonable costs.
[4] On April 16, 2021, the FDA revoked the EUA that allowed for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients. As a result, Medicare won't pay for claims with HCPCS codes M0239 or Q0239 with dates of service after April 16, 2021.
[5] On June 3, 2021, the FDA revised the EUA for casirivimab and imdevimab to change the allowed dosing regimen from 2400 mg to 1200 mg and allow providers to administer the combination product by subcutaneous injection in limited circumstances. As a result, CMS issued a new product code for casirivimab and imdevimab (Q0244) and updated the descriptors for the existing administration codes (M0243/M0244).
[6] On July 30, 2021, the FDA revised the EUA for casirivimab and imdevimab to allow its use for post-exposure prophylaxis (PEP) in certain adult and pediatric patients. For patients who meet the criteria for repeat dosing, the authorized dosage is an initial dose of 1200 mg, followed by subsequent repeat dosing of 600 mg once every 4 weeks for the duration of ongoing exposure. As a result, CMS issued a new product code for casirivimab and imdevimab of 600 mg (Q0240) and 2 new codes for the administration of repeat doses of casirivimab and imdevimab (M0240/M0241). Providers who administer casirivimab and imdevimab for PEP should use M0243 or M0244 for administering the first dose and M0240 or M0241 for administering subsequent repeat doses.
[7] When the government provides monoclonal antibody products to treat COVID-19 for free, providers should only bill for the administration. Don’t include the monoclonal antibody product codes on these claims. If you got the product for free and your systems require a product code to bill for the administration, enter $0.01 for the billed amount.
[8] On September 16, 2021, the FDA revised the EUA for bamlanivimab and etesevimab administered together, to allow its use for post-exposure prophylaxis (PEP) in certain adult and pediatric patients. Providers should use Q0245 and M0245 or M0246 to bill for administering bamlanivimab and etesevimab for PEP between September 16, 2021 – December 14, 2023. On December 14, 2023, the FDA revoked the EUA for bamlanivimab and etesevimab administered together.
[9] On January 24, 2022, the FDA announced that, due to the high frequency of the Omicron variant, REGEN-COV (casirivimab and imdevimab, administered together) isn’t currently authorized in any U.S region. Therefore, you may not administer REGEN-COV for treatment or post-exposure prevention of COVID-19 under the EUA until further notice.
[10] On April 5, 2022, the FDA announced that, due to the high frequency of the Omicron BA.2 sub-variant, sotrovimab isn’t currently authorized in any U.S. region. Therefore, you may not administer sotrovimab to treat COVID-19 under the EUA until further notice.
[11] On November 30, 2022, the FDA announced that bebtelovimab isn’t currently authorized in any U.S. region because it isn’t expected to neutralize Omicron sub-variants BQ.1 and BQ.1.1. Therefore, you may not administer bebtelovimab to treat COVID-19 under the EUA until further notice.
[12] On January 26, 2023, the FDA announced that EVUSHELD isn’t currently authorized for emergency use in the U.S.
Geographically Adjusted Payment Rates for 2025
2025 Geographically-Adjusted Payment Rates for Monoclonal Antibody Administration (ZIP) [For claims with dates of service 1/1/2025-12/31/2025]
- Additional COVID-19 Information
- Get HCPCS codes for each product and its administration:
- COVID-19 CPT vaccine and immunization codes - AMA: View for long, medium, and short descriptions of COVID-19 CPT codes
- COVID-19 NDC-HCPCS crosswalk
- CDC COVID-19 Vaccination Resources
- COVID-19 Vaccination Training Programs and Reference Materials for Healthcare Professionals
- Information about Public Health Emergency
- COVID-19 Monoclonal Antibodies
- Quick reference guide to the coding structure for COVID-19 vaccine CPT reporting
- COVID-19 provider toolkit: Get more information about Medicare and COVID-19
- Vaccine Authorization Letters & Fact Sheets
- Monoclonal Antibody EUAs & Fact Sheets for Healthcare Providers
- ACTEMRA® (tocilizumab): EUA and EUA Fact Sheet
- Bamlanivimab: EUA and EUA Fact Sheet
- Bamlanivimab and etesevimab: EUA and EUA Fact Sheet
- Bebtelovimab: EUA and EUA Fact Sheet
- EvusheldTM (tixagevimab co-packaged with cilgavimab): EUA and EUA Fact Sheet
- PEMGARDA (pemivibart): EUA and EUA Fact Sheet
- REGEN-COV® (casirivimab and imdevimab): EUA and EUA Fact Sheet
- Sotrovimab: EUA and EUA Fact Sheet
- Get HCPCS codes for each product and its administration:
- Archive: Previous Year Resources
- 2023 - 2024 COVID-19 Vaccines (PDF)
- 2020 - 2023 COVID-19 Vaccines (PDF)
- Geographically-adjusted Payment Rates (By Year)
- 2024
- Jan 1 - Dec 2024 Geographically-adjusted Payment Rates for COVID-19 Vaccine Administration & In-Home Additional Payment (ZIP) [For claims with dates of service 1/1/2024-12/31/2024]
Jan 1 - Dec 2024 Geographically-adjusted Payment Rates for Monoclonal Antibody Administration (ZIP) * Updated 04/02/2024 to reflect the new codes for PEMGARDA [For claims with dates of service 03/22/2024-12/31/2024]
- 2023
- Jan - Dec 2023 Geographically-adjusted Payment Rates for COVID-19 Vaccine Administration (ZIP) [For claims with dates of service 10/03/2023 through 12/31/2023] *Updated 10/05/2023 to remove codes describing the service to administer COVID-19 vaccines that are no longer authorized in the U.S. for the Novavax vaccine, Adjuvanted (effective 10/03/2023)
- Jan - Dec 2023 Geographically-adjusted Payment Rates for Monoclonal Antibody Administration (ZIP) [For claims with dates of service 01/01/2023 through 12/31/2023] *Updated 07/14/2023 to reflect locality revisions for Puerto Rico (PR) and the Virgin Islands (VI)
- 2022
- Jan - Dec 2022 Geographically-adjusted Payment Rates for COVID-19 Vaccine Administration (for Providers & Suppliers Paid MPFS-Adjusted Rates) (ZIP) *Updated 12/20/2022 to reflect the new codes for Moderna and Pfizer-BioNTech pediatric bivalent (updated COVID-19 vaccines) booster dose/
- Jan - Dec 2022 Geographically-adjusted Payment Rates for Monoclonal Antibody Administration (for Providers & Suppliers Paid MPFS-Adjusted Rates) (ZIP) *Updated 02/17/2022 to reflect the new codes for bebtelovimab [For claims with dates of service 02/11/2022 through 12/31/2022]
- Jan - Dec 2022 Geographically-adjusted Payment Rates for COVID-19 Vaccine Administration (for Providers & Suppliers Paid MPFS-Adjusted Rates) (ZIP) *Updated 12/20/2022 to reflect the new codes for Moderna and Pfizer-BioNTech pediatric bivalent (updated COVID-19 vaccines) booster dose/
- 2021
- Jan - March 2021 Geographically-adjusted Payment Rates for COVID-19 Vaccine Administration (for Providers & Suppliers Paid MPFS-Adjusted Rates) (ZIP) *Updated 02/16/2021 for addition of the COVID-19 Janssen vaccine* [For claims with dates of service of 1/1/2021 through 3/14/2021]
- March - Dec 2021 Geographically-adjusted Payment Rates for COVID-19 Vaccine Administration (for Providers & Suppliers Paid MPFS-Adjusted Rates) (ZIP) *Updated 11/02/2021 to account for effective dates for Pfizer-BioNTech COVID-19 Pediatric Vaccine [For claims with dates of service 3/15/2021 through 12/31/2021]
- 2024