National Government Services (NGS) has released its Part B allowance limits for the 2023-2024 influenza vaccine products at 95% of the Average Wholesale Price (APW). The flu season is August 1, 2023, through July 31, 2024. As a reminder, under Part B for Medicare members, flu vaccine products and their administration are a fully covered benefit; patient cost share does not apply.
NGS will release an update to the payment allowances for COVID-19 vaccine products and monoclonal antibodies at a later date. COVID-19 vaccines are not billable when providers have not incurred a cost for the product. The COVID-19 public health emergency ended on May 11, 2023; please review member benefits for cost-share conditions.
Please visit the link below for specific vaccine allowances and effective dates by-product.
