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Last Modified: 3/29/2018 Location: FL, PR, USVI Business: Part B

Pneumococcal and influenza virus vaccine administration FAQ

Q: How do I find fee schedule information regarding pneumococcal and influenza virus vaccine administration? I tried searching the Medicare Physician Fee Schedule (MPFS) using HCPCS codes “G0008” and “G0009,” but I couldn’t find any payment information.
A: According to Medicare Claims Processing Manual, Chapter 18 (Preventing and Screening Services) external pdf file, the guidelines for pricing pneumococcal and influenza virus vaccine administration under the Medicare Physician Fee Schedule (MPFS) are as follows:
Effective on and after March1, 2003, reimbursement for HCPCS code “G0009” should be made based upon the rate in the MPFS associated with Current Procedural Terminology (CPT®) code 90471.
Effective on and after March1, 2003, reimbursement for HCPCS code “G0008” should be made based upon the rate in the MPFS associated with CPT® code 90471.
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Source: Medicare Claims Processing Manual, Chapter 18
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