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2020 – 2021 Influenza Season Information

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2020 – 2021 Influenza Season Information

Date Issued: 09/28/2020

All EmblemHealth members are covered for the flu vaccine. Below are the Influenza Vaccine codes we cover. For a printable version of this chart suitable for sharing with your staff or posting in treatment areas, click here.

2020 – 2021 Influenza Season Information

Medicare Codes for Flu Vaccinations

Commercial Codes for Flu Vaccinations

Medicaid (FFS) Codes for Flu Vaccinations

90653

90686

90653

90686

90653

90686

90662

90687

90662

90687

90662

90687

90672

90688

90672

90688

90672

90688

90674

90694

90674

90694

90674

90694

90682

90756

90682

90756

90682

90756

90685

90685

90685

Administration Code: G0008

Administration Codes: 90460, 90461, 90471, 90472, 90473 and 90474

Administration Codes for members 19 y/o and younger: 90460 (VFC)

Administration Codes for members 19 y/o and older: 90471, 90472, and 90473



For most members, there is no copayment, coinsurance or deductible if the only service that is provided during the visit is the administration of a flu shot. If there is an additional, separate reason billed for a visit, applicable copayment, coinsurance and deductible will apply.


If a member receives a flu vaccination from a non-participating provider, we cover the usual-and-customary amount. If a member pays out of pocket, he or she can provide a receipt to us along with a completed Out-of-Plan Reimbursement Form.

 

Medicare members should use this Medicare Out-of-Plan Reimbursement Form.

 

Medicaid Managed Care (MMC) members will continue to access immunization services through their health plans. For Medicaid Managed Care Organization (MCO) billing guidance please contact the plan. Individual plan information can be found at: https://mmcdruginformation.nysdoh.suny.edu/

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New CDC Recommendations for Flu Vaccines There’s Still Time to Recommend the Flu Vaccine! 2020-2021 Annual Provider Notification

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© 2020 EmblemHealth. All Rights Reserved.

Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.

Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.