2024 influenza, pneumococcal, and hepatitis B vaccine reimbursement

Vaccine fees

Please refer to the Medicare Preventive Services Educational Tool for policy and frequency guidelines.

Payment allowances for codes for which products have not yet been approved will be provided when the products have been approved and pricing information becomes available to CMS.

Influenza (flu) vaccine

The annual influenza vaccine season runs from August 1 through July 31 of the following year.

Payment allowances and effective dates for the 2024-2025 flu season is available on the CMS Seasonal Influenza Vaccines Pricing page. 

Once on this page, click the "Seasonal Flu Vaccines". 

Pneumococcal (PPV) and hepatitis B vaccines

Payment allowances and effective dates for the PPV and hepatitis B vaccines are available on the ASP Drug Pricing page.

Payment allowances for codes for which products have not yet been approved will be provided when the products have been approved and pricing information becomes available to CMS.

Administration fees

The 2024 influenza, pneumococcal, and hepatitis B vaccine administration reimbursement rate is identical for all three administration codes.

G0008 - administration of influenza virus vaccine.

G0009 - administration of pneumococcal vaccine. 

G0010 - administration of hepatitis B vaccine.

M0201 - administration of vaccine in the home.

For claims with dates of service on or after January 1 through December 31, the national payment rate for HCPCS codes G0008, G0009, and G0010 is $32.57, M0201 is $38.00. 

CMS has established codes and fees based on the geographically adjusted payment allowances for these codes. 

For providers and suppliers with payments that are geographically adjusted by the methodology used by the Medicare Physician Fee Schedule (MPFS), the geographically adjusted payment rates are listed below.

Note: Centralized billers cannot bill for G0010.