2011-2012 Billing for Flu Shots
Upon direction from TRICARE Management Activity (TMA), TriWest Healthcare Alliance (TriWest) will be following the latest Centers for Medicare & Medicaid Services' billing guidelines for the 2011-2012 flu season. The change is retroactive to January 1, 2011.
The following Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are recommended for billing. There is currently CHAMPUS Maximum Allowable Charge (CMAC) pricing for these codes:
Note: 90662 - Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content for intramuscular use is on the No Government Pay Procedure Code List and is not reimbursable.
Upon direction from TRICARE Management Activity (TMA), TriWest Healthcare Alliance (TriWest) will be following the latest Centers for Medicare & Medicaid Services' billing guidelines for the 2011-2012 flu season. The change is retroactive to January 1, 2011.
The following Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are recommended for billing. There is currently CHAMPUS Maximum Allowable Charge (CMAC) pricing for these codes:
- 90655 - Influenza virus vaccine, split virus, preservative free, when administered to children 6-o35 mnths of age for intramuscular use
- 90656 - Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older for intramuscular use
- 90657 - Influenza virus vaccine, split virus, when administered to children 6-35 months of age for intramuscular use
- 90660 - Influenza virus vaccine, live, for intranasal use
- Q2035 - Influenza virus, spit virus, when administered to individuals 3 years of age and older for intramuscular use (Afluria)
- Q2036 - Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older for intramuscular use (Fluaval)
- Q2038 - Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older for intramuscular use (Fluzone)
Note: 90662 - Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content for intramuscular use is on the No Government Pay Procedure Code List and is not reimbursable.
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