This page is a central location for immunization service provider information, including CMS resources. 

Spotlight

Visit the CMS Vaccine Pricing webpage to obtain 2026–2027 seasonal influenza and COVID-19 vaccine pricing, including Medicare payment allowances and effective dates.

Enrolling

The following resource supports enrollment activities for immunizations:

• Mass Immunization Roster Billers

Policy Information

Not all services have a policy associated with them. We will consider Reasonable and Necessary Guidelines in the absence of an LCD, billing and coding article, NCD, or CMS manual instruction that limits coverage.

LCDs

Learn more about the LCD development process through the following:

• LCD Development Process
• Journey to LCD Coverage

Search for immunization service-related LCDs using these available resources:

• LCD Interactive Index Tool
• View active / proposed LCDs on CMS’ Medicare Coverage Database (MCD)

NCDs
Search for immunization service-related NCDs using these available tools:

• Search CMS MCD

Medical Documentation

For a claim to be valid, documentation must demonstrate compliance with all applicable coverage, coding and billing requirements and substantiate the level of care billed. The following resources are specific to immunizations but may not address all required medical documentation requirements:

• CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15, Section 50.4.4.2
• CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 18, Section 10

Claim Submission and Reimbursement

• Vaccine Pricing - Influenza, COVID-19, Pneumococcal, and Hepatitis B Vaccines
• 2026 - 2027 Influenza, COVID-19, Pneumococcal, and Hepatitis B Vaccine Reimbursement
• 2025 Influenza, Pneumococcal, and Hepatitis B Vaccine Reimbursement

• COVID-19 Vaccine and Monoclonal Antibodies Billing for Part A

• COVID-19 Vaccine and Monoclonal Antibody Billing for Part B Providers

• PC-ACE User Guide: Section 5 - Flu, Pneumonia, COVID-19, Hepatitis B, or Monoclonal Antibody (mAb) Infusion Injection Roster Billing

• Roster Billing for Part A 

• Roster Billing for Part B

• Influenza Vaccine Roster Form

• Pneumococcal Vaccine Roster Form

• Hepatitis B Vaccine Roster Form

• COVID-19 Vaccine or Monoclonal Antibody Infusion Roster Form

Additional Information

• View our FastTrack to Medicare Coverage Policies Tool to locate guidelines
• SPOT User Guide: Section 3 - Eligibility

CMS

• COVID-19 Vaccine Provider Toolkit
• MLN Connects Newsletter for September 10, 2026: Claims, Pricers & Codes - COVID-19 Vaccine: Updated Pricing for 2026–2027 Season
• MLN Educational Tool MLN006559, Medicare Preventive Services
• MLN Fact Sheet MLN908764, Medicare Part D Vaccines
• MLN Matters Article MM14470, Vaccine Administration National Fee Schedule: July 2026 Quarterly Update
• MLN Matters Article MM13937, Roster Billing for Hepatitis B: July 2025 Release
• Preventive Services - Shots & Vaccines

Education

View our wide selection of free, live and on-demand training options:

• View our upcoming Education Events Calendar
• View On-Demand Learning

Stay Informed

Stay updated on the latest Medicare information with free email subscriptions:

• Subscribe to eNews
• CMS.gov MLN Connects Newsletter