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Tag Archives: allowances

Medicare payment allowances for flu vaccines

Posted on September 26, 2018 by CPC Exam Medical Coding Updates

The Medicare Part B payment allowances for dates of service of August 1, 2018, through July 31, 2019 is furnished below. The allowances are still pending for the following codes 90630, 90653, 90654, 90655, 90656, 90657, 90661, 90662, 90672, 90673, 90674, 90682, 90685, 90686, 90687, 90688, 90756, Q2036, Q2037, and Q2038.

90653 Fluad $ 54.67 
90656 Afluria $ 19.77 
90662 Fluzone High-Dose $ 53.37 
90674 Flucelvax Quadrivalent $ 24.05 
90682 Flublok Quadrivalent $ 53.37 
90685 Fluzone Quadrivalent Pediatric $ 21.81 
90686 Afluria Quadrivalent, Fluarix Quadrivalent, Flulaval Quadrivalent, Fluzone Quadrivalent [Preservative Free] $ 19.03 
90687 Fluzone Quadrivalent Pediatric $ 9.40 
90688 Afluria Quadrivalent, Flulaval Quadrivalent, Fluzone Quadrivalent $ 17.84 
90756 Flucelvax Quadrivalent $ 22.79 
Q2035 Afluria $ 18.24 

Note: Annual Part B deductible and coinsurance amounts do not apply.

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Payment Allowances and Effective Dates of for the 2014-2015 Flu Season

Posted on November 26, 2016 by CPC Exam Medical Coding Updates

CPT 90654 Payment allowance is $ 18.918. Effective dates: 8/1/2014-7/31/2015
CPT 90655 Payment allowance is pending. Effective dates: 8/1/2014-7/31/2015
CPT 90656 Payment allowance is $ 14.096. Effective dates: 8/1/2014-7/31/2015
CPT 90657 Payment allowance is $ 6.022. Effective dates: 8/1/2014-7/31/2015
CPT 90661 Payment allowance is $ 21.666. Effective dates: 8/1/2014-7/31/2015
CPT 90662 Payment allowance is $ 33.374. Effective dates: 8/1/2014-7/31/2015
CPT 90672 Payment allowance is $ 25.736. Effective dates: 8/1/2014-7/31/2015
CPT 90673 Payment allowance is $ 37.193 Effective dates: 9/26/2014-7/31/2015
CPT 90685 Payment allowance is $ 23.900. Effective dates: 8/1/2014-7/31/2015
CPT 90686 Payment allowance is $ 17.984. Effective dates: 8/1/2014-7/31/2015
CPT 90687 Payment allowance is $ 9.134. Effective dates: 8/1/2014-7/31/2015
CPT 90688 Payment allowance is $ 16.844. Effective dates: 8/1/2014-7/31/2015
HCPCS Q2035 Payment allowance is $ 11.885. Effective dates: 8/1/2014-7/31/2015
HCPCS Q2036 Payment allowance is $ 8.579. Effective dates: 8/1/2014-7/31/2015
HCPCS Q2037 Payment allowance is $ 15.396. Effective dates: 8/1/2014-7/31/2015
HCPCS Q2038 Payment allowance is $ 12.044. Effective dates: 8/1/2014-7/31/2015
HCPCS Q2039 Flu Vaccine Adult – Not Otherwise Classified payment allowance is to be determined by the local claims processing contractor with effective dates of 8/1/2014-7/31/2015

Reference: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/VaccinesPricing.html

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Clinical laboratory fee schedule on travel allowances and specimen collection fees

Posted on October 14, 2016 by CPC Exam Medical Coding Updates

The Centers for Medicare & Medicaid Services (CMS) updated payment rates for travel allowances and specimen collection fees when billed on a per mileage basis using Health Care Common Procedure Coding System (HCPCS) code P9603 and when billed on a flat rate basis using HCPCS code P9604 for 2016.

Payment of the travel allowance is made only if a specimen collection fee is also payable. The travel allowance is intended to cover the estimated travel costs of collecting a specimen including the laboratory technician’s salary and travel expenses. The per mile travel allowance is to be used in situations where the average trip to the patients’ homes is longer than 20 miles round trip.

The per flat-rate trip basis travel allowance is $ 9.90

Reference: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9485.pdf

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