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Medicare publishes 2019-2020 influenza vaccine pricing

November 01, 2019
Area(s) of Interest: Public Health Public Payors 


The Center for Medicare and Medicaid Services (CMS) recently published Medicare’s influenza vaccine payment allowances and effective dates for the 2019-2020 flu season.

The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are calculated at 95% of the average wholesale price.

The payment allowances and effective dates for the 2019-2020 flu season are as follows:​

Code Labeler Name Drug Name Payment Allowance Effective Dates
90653 Seqirus Fluad (2019/2020) $59.530 08/01/2019 - 07/31/2020
90662 Sanofi Pasteur Fluzone High-Dose (2019/2020) $56.006 08/01/2019 - 07/31/2020
90672 MedImmune FluMist Quadrivalent (2019/2020) $26.876 08/01/2019 - 07/31/2020
90674 Seqirus Flucelvax Quadrivalent (2019/2020) $28.130 08/01/2019 - 07/31/2020
90682 Sanofi Pasteur Flublok Quadrivalent (2019/2020) $56.006 08/01/2019 - 07/31/2020
90685 Sanofi
Pasteur
Seqirus

Fluzone Quadrivalent
0.25ml (2019/2020)
(Pres Free)

Afluria Quadrivalent
0.25ml (2019/2020)
(Pres Free)

$20.343 08/01/2019 - 07/31/2020
90686 GlaxoSmithKline 
Sanofi Pasteur
Seqirus

Fluarix Quadrivalent
(2019/2020)
(Pres Free)

Flulaval Quadrivalent
(2019/2020)
(Pres Free)

Fluzone Quadrivalent
(2019/2020)
(Pres Free)

Afluria Quadrivalent
(2019/2020)
(Pres Free)

$19.032 08/01/2019 - 07/31/2020
90687 Sanofi Pasteur
Seqirus

Fluzone Quadrivalent
0.25ml (2019/2020)

Afluria Quadrivalent
0.25ml (2019/2020)

$9.403 08/01/2019 - 07/31/2020
90688 GlaxoSmithKline  
Sanofi Pasteur
Seqirus

Flulaval Quadrivalent
(2019/2020)

Fluzone Quadrivalent
(2019/2020)

Afluria Quadrivalent
(2019/2020)

$17.835 08/01/2019 - 07/31/2020
90756 Seqirus Flucelvax Quadrivalent
(2019/2020)
$26.657 08/01/2019 - 07/31/2020

 

More information on 2019-2020 influenza vaccine pricing is available on the CMS website.

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