CPT Q2035, Q2036, Q2037, Q2038 -Medicare update on influenza vaccine -

We would like to inform that effective from the dates of services Jan 1, 2011 CPT 90658 (Influenza vaccine) would not be paid by Medicare and replaced with the below mentioned codes.

Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria)

Q2036 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval)

Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin)

Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)

Q2039 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Not Otherwise Specified


Effective for claims with dates of service on or after October 1, 2010, the following HCPCS codes will be payable for Medicare: 

HCPCS Code Short Description Long Description

Q2035 Afluria vacc, 3 yrs & >, im Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria) Q2036 Flulaval vacc, 3 yrs & >, im

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval) Q2037 Fluvirin vacc, 3 yrs & >, im

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin) Q2038 Fluzone vacc, 3 yrs & >, im

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone) Q2039 NOS flu vacc, 3 yrs & >, im 

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Not Otherwise Specified) 

Take Note: CPT 90658 describes the regular dose vaccine that is supplied in a multidose vial for use in patients over 3 years of age. For dates of service on or after October 1, 2010, HCPCS codes Q2035, Q2036, Q2037, Q2038 and Q2039 (as listed in the table above) will replace the CPT code 90658 for Medicare payment purposes during the 2010 – 2011 influenza season. However, these HCPCS codes will not be recognized by the Medicare claims processing systems until January 1, 2011, when CPT code 90658 will no longer be recognized. 

HCPCS Code Allowance

Q2036 $8.784
Q2037 $13.253

Q2038 $12.593

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