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Pricing for the new FDA Approved COVID Vaccines and annual Flu Vaccine has been posted to the CMS vaccine pricing webpage.






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ASP Announcement




*September 5, 2024 *

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What’s New?

*COVID-19: FDA approves COVID-19 Vaccines for the 2024-2025 Season*

On August 22, 2024, FDA approved updated mRNA COVID-19 Vaccines made by Pfizer and Moderna [ https://vmm0dj30.r.us-west-2.awstrack.me/L0/https:%2F%2Fwww.fda.gov%2Fnews-events%2Fpress-announcements%2Ffda-approves-and-authorizes-updated-mrna-covid-19-vaccines-better-protect-against-currently/1/01010191c2a308e5-a34c5b8b-dc1c-4c94-98d9-a6c2511b46cc-000000/ZrM-eqscj4eWWSie2POaAOYl7i8=391 ]. Novavax’s COVID-19 Vaccine was also approved shortly thereafter [ https://vmm0dj30.r.us-west-2.awstrack.me/L0/https:%2F%2Fwww.fda.gov%2Fnews-events%2Fpress-announcements%2Ffda-authorizes-updated-novavax-covid-19-vaccine-better-protect-against-currently-circulating/1/01010191c2a308e5-a34c5b8b-dc1c-4c94-98d9-a6c2511b46cc-000000/do-7smtcyLCC8sb2I-hngjiP_EY=391 ] on August 30, 2024. The vaccines are formulated to target currently circulating variants and provide better protection again serious consequences of COVID-19, including hospitalization and death. The Pfizer [ https://vmm0dj30.r.us-west-2.awstrack.me/L0/https:%2F%2Fwww.fda.gov%2Fvaccines-blood-biologics%2Fcoronavirus-covid-19-cber-regulated-biologics%2Fpfizer-biontech-covid-19-vaccine/1/01010191c2a308e5-a34c5b8b-dc1c-4c94-98d9-a6c2511b46cc-000000/upCvX02obKJt_X9BLuasbjax5qI=391 ] and Moderna [ https://vmm0dj30.r.us-west-2.awstrack.me/L0/https:%2F%2Fwww.fda.gov%2Fvaccines-blood-biologics%2Fcoronavirus-covid-19-cber-regulated-biologics%2Fmoderna-covid-19-vaccine/1/01010191c2a308e5-a34c5b8b-dc1c-4c94-98d9-a6c2511b46cc-000000/rEKdcZX36lk2ISPl0ht73-j0gqw=391 ] vaccines have been updated to include a monovalent (single) component that corresponds to the Omicron variant KP.2 strain of SARS-CoV-2. Novavax [ https://vmm0dj30.r.us-west-2.awstrack.me/L0/https:%2F%2Fwww.fda.gov%2Fvaccines-blood-biologics%2Fcoronavirus-covid-19-cber-regulated-biologics%2Fnovavax-covid-19-vaccine-adjuvanted/1/01010191c2a308e5-a34c5b8b-dc1c-4c94-98d9-a6c2511b46cc-000000/f3Dhiy6831PnBpMigaBPVbdTYL4=391 ] includes a monovalent (single) component that corresponds to the Omicron variant JN.1 strain of SARS-CoV-2.  

CMS has updated payment allowances for the following CPT codes: 91304, 91318, 91319, 91320, 91321, and 91322.

*Please note the effective date of each new vaccine price: *


* CPT 91318, 91319, 91320, CPT 91321, and CPT 91322
* Effective date: 08/22/2024 to TBD
* "Note:" Payment allowance remains unchanged from the last vaccine season for CPT 91318 and 91319

* CPT 91304
* Effective Date: 08/30/2024 to TBD

Visit the CMS vaccine pricing webpage [ https://www.cms.gov/medicare/payment/part-b-drugs/vaccine-pricing ] for details of the most current list of billing codes, including short descriptors, payment allowances, and effective dates [ https://www.cms.gov/medicare/payment/part-b-drugs/vaccine-pricing ].

Visit the COVID-19 Vaccine Provider Toolkit [ https://www.cms.gov/covidvax-provider ] for more information.



Centers for Medicare & Medicaid Services




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