Immunization billing will be changing in 2011, as new codes take effect for Medicare and pediatric patients on the private-payer side.

What’s new?
The familiar 90658 code is no longer payable. New, Q codes took its place.

What they mean
The new codes show the brand of flu vaccine and were put in place to separate each one.

Each brand has a different cost to Medicare, and the new codes reflect that.

Q codes
Q2035 (Afluria ) Your carrier or Medicare Administrative Contractor will set payment limits.

Q2036 (Flulaval) National limit is $7,439.

Q2037 (Fluvirin) National limit is $13,253.

Q2038 (Fluzone) National limit is $12,593.

Q2039 (Non-specified flu vaccine) No national payment limit, so MAC will set the limit.

The national limit is the maximum possible payment but prices could vary.

We hope this information from ECP researchers help your billing department assure correct payment for claims.  Please contact us if you have any questions.