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Billing Codes and Recommendations for Flu Vaccination

Date: 12/26/23

As a reminder, Superior HealthPlan Medicaid (STAR, STAR Health, STAR Kids and STAR+PLUS) and CHIP members 3 years of age and older have the option to obtain their flu vaccine with their Superior medical provider or at a participating pharmacy. The vaccination is also available to Wellcare By Allwell (HMO and HMO DSNP), Ambetter from Superior HealthPlan and Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) members, if provided by a participating pharmacy and/or medical provider licensed to administer the shot. 

The optimal time for patients to receive the flu vaccine is as early in the season as it is available. The duration of flu season can vary, but the Centers for Disease Control and Prevention (CDC) considers the season to run from October to May. The CDC recommends:

  • Flu vaccinations to start in October and continue through March for optimal influenza protection.
  • Everyone 6 months of age and older, without a contraindication, receive their flu vaccination by the end of October.
    • Some children, aged 6 months through 8 years, require 2 doses of flu vaccines. These children should receive their first dose as soon as possible after the vaccine becomes available, and the second dose 4 weeks later. 
  • Members who are not able to get vaccinated until November or later, should still get vaccinated.
    • The flu most commonly peaks in February and significant activity can continue into May.
  • Beginning with the 2023-2024 season, the CDC no longer recommends additional safety measures for administering flu vaccines to those with egg allergies, regardless of allergy severity. People with any level of egg allergy, including severe allergy with symptoms beyond hives, may receive an age-appropriate flu vaccine. All vaccines should be given in settings where allergic reactions can be recognized and treated quickly.  

Providers should encourage their patients to seek their flu vaccination in a timely manner each fall. Getting a flu vaccine during 2023-2024 is more important than ever due to the COVID-19 pandemic. Flu vaccines and COVID-19 vaccines can be given at the same time. It is especially important for individuals who are at a higher risk of developing serious flu-related complications that are more likely to lead to hospitalization or death. High-risk individuals include, but are not limited to:

  • Children younger than 2 years of age.
  • Pregnant women and women up to 2 weeks after the end of pregnancy.
  • Immunosuppressed individuals.
  • Residents of nursing homes and other long-term care facilities.
  • People with certain chronic health conditions, such as:
    • Chronic lung disease (including asthma).
    • Heart disease.
    • Renal disease.
    • Metabolic disease (such as diabetes).
    • Hematologic disease.
    • Neurologic disease.
  • American Indians/Alaska Natives.
  • People with morbid obesity (body mass index ≥40 for adults).
  • People 65 years of age or older.
  • People who have had a stroke.

For more information about the 2023-2024 seasonal flu recommendations, please visit the CDC’s Frequently Asked Influenza Questions for the 2023-2024 Season Website.

See below for flu vaccine billing code information:

APPROVED INFLUENZA VACCINE BILLING CODES:

90662

90672

90674

90682

90685

90686

90687

90688

 90694

90756

 

 

 

APPROVED INFLUENZA VACCINE ADMINISTRATION CODES:

90460

90471

90473

90461

90472

90474

Please note: Hospital-based Rural Health Clinics (RHC) must submit claims for influenza vaccines as non-RHC services, under their hospital provider identifier.

For any questions or additional information, please contact Provider Services at 1-877-391-5921.