New Q Codes Required For Billing Flu Vaccines to Medicare

December 6th, 2010

CMS has created specific HCPCS codes and payment rates for Medicare billing purposes for this flu season. Effective for claims with dates of service on or after January 1, 2011, CPT code 90658 will no longer be paid by Medicare.  As of October 1, 2010, the following new influenza Q codes became payable by Medicare:      Q2035 (Afluria),      Q2036 (Flulaval),      Q2037 (Fluvirin),      Q2038 (Fluzone), and      Q2039 (Not Otherwise Specified                  flu vaccine).
 
However, providers using these codes will not be paid for using these codes immediately.    The Medicare contractors’ have until February 7, 2011 to program their software to accept the codes. Medicare institutional providers also have the option to hold their claims containing the new influenza Q codes until February 7, 2011. Best advice:  vaccinate before the end of the year and use the old, still accepted codes.  After January 1, use the new Q codes.  
 
For further information, please see http://www.cms.gov/Transmittals/2010Trans/list.asp.

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