TL;DR
CMS's 2026-2027 seasonal vaccine price file lists 15 influenza and COVID-19 vaccine codes (9 influenza, 6 COVID-19) with payment allowance limits effective August 1, 2026 through July 31, 2027 unless a later start date is noted. The limits are 95% of average wholesale price; Medicare Part B pays them with no deductible or coinsurance, and the companion crosswalk ties 18 NDCs to their codes.
The 2026-2027 files
- Vaccine codes
- 15
- 9 influenza, 6 COVID-19
- NDC rows in the crosswalk
- 18
- Season
- August 1, 2026 to July 31, 2027
- Pricing basis
- 95% of AWP
- Vaccine AWP% column
- Patient cost sharing
- None
- Coinsurance 0% for every code
- Later start dates
- 8
- Codes whose limit starts after August 1
2026-2027 vaccine codes, products and payment limits
One row per product NDC. The payment limit is per billing unit of the code (one dose); the billing units per package come from the CMS crosswalk, so a 10-dose package of a 1-unit code is 10 units.
| Code | Product and labeler | NDC | Dose | Units per package | Payment limit | Effective |
|---|---|---|---|---|---|---|
| 90616Influenza | mFLUSIVA Trivalent (2026/2027)Moderna | 80777-0500-20 | 0.38 ML | 10 | $171.211 | August 5, 2026 |
| 90653Influenza | Fluad Trivalent (2026/2027) (Preservative Free)Seqirus Inc | 70461-0026-03 | 0.5 ML | 10 | $122.522 | Aug 1, 2026 |
| 90656Influenza | Fluarix Trivalent (2026/2027) (Preservative Free)GlaxoSmithKline | 58160-0725-52 | 0.5 ML | 10 | $23.889 | Aug 1, 2026 |
| 90656Influenza | FluLaval Trivalent (2026/2027) (Preservative Free)GlaxoSmithKline | 19515-0822-52 | 0.5 ML | 10 | $23.889 | Aug 1, 2026 |
| 90656Influenza | Fluzone Trivalent (2026/2027) (Preservative Free)Sanofi Pasteur | 49281-0426-50 | 0.5 ML | 10 | $23.889 | Aug 1, 2026 |
| 90657Influenza | Fluzone Trivalent (2026/2027)Sanofi Pasteur | 49281-0645-15 | 0.25 ML | 20 | $11.141 | Aug 1, 2026 |
| 90658Influenza | Fluzone Trivalent (2026/2027)Sanofi Pasteur | 49281-0645-15 | 0.5 ML | 10 | $22.281 | Aug 1, 2026 |
| 90660Influenza | FluMist Trivalent (2026/2027)MedImmune | 66019-0113-10 | 0.2 ML | 10 | $30.581 | August 24, 2026 |
| 90660Influenza | FluMist Trivalent (2026/2027)MedImmune | 66019-0113-51 | 0.2 ML | 1 | $30.581 | August 24, 2026 |
| 90661Influenza | Flucelvax Trivalent (2026/2027) (Preservative Free)Seqirus Inc | 70461-0656-03 | 0.5 ML | 10 | $66.569 | Aug 1, 2026 |
| 90662Influenza | Fluzone High-Dose (2026/2027) (Preservative Free)Sanofi Pasteur | 49281-0126-65 | 0.5 ML | 10 | $122.522 | Aug 1, 2026 |
| 90673Influenza | Flublok Trivalent (2026/2027) (Preservative free)Sanofi Pasteur | 49281-0726-10 | 0.5 ML | 10 | $122.522 | Aug 1, 2026 |
| 91304COVID-19 | Nuvaxovid (COVID-19 Vaccine) (2026/2027)Novavax | 49281-0026-50 | 0.5 ML | 10 | $232.218 | August 27, 2026 |
| 91319COVID-19 | Comirnaty (COVID-19 Vaccine, mRNA) (2026/2027)Pfizer | 00069-2609-10 | 0.3 ML | 10 | $103.33 | August 27, 2026 |
| 91320COVID-19 | Comirnaty (COVID-19 Vaccine, mRNA) (2026/2027)Pfizer | 00069-2631-10 | 0.3 ML | 10 | $230.405 | August 27, 2026 |
| 91321COVID-19 | Spikevax (COVID-19 Vaccine, mRNA) (2026/2027)Moderna | 80777-0115-80 | 0.25 ML | 10 | $172.967 | August 27, 2026 |
| 91322COVID-19 | Spikevax (COVID-19 Vaccine, mRNA) (2026/2027)Moderna | 80777-0114-96 | 0.5 ML | 10 | $172.967 | August 27, 2026 |
| 91323COVID-19 | mNEXSPIKE (COVID-19 Vaccine, mRNA) (2026/2027)Moderna | 80777-0401-60 | 0.2 ML | 10 | $252.225 | August 27, 2026 |
Not every limit starts on August 1. The price file gives later start dates for 90616 (August 5, 2026), 90660 (August 24, 2026), 91304 (August 27, 2026), 91319 (August 27, 2026), 91320 (August 27, 2026), 91321 (August 27, 2026), 91322 (August 27, 2026), 91323 (August 27, 2026); a claim for an earlier date of service has no limit for that code. Higher-cost products such as Fluzone High-Dose (90662, $122.522) bill under their own code, so the code on the claim must match the product actually given.
Which code does each brand use?
The brand names below are the product names in the CMS 2026-2027 NDC crosswalk. A brand can map to more than one code when it comes in several doses or presentations.
Administration codes
The vaccine and its administration are separate lines. These Level II codes carry public descriptors; each shows status X in the October 2026 physician fee schedule file because its payment is not computed from RVUs.
| Code | HCPCS descriptor |
|---|---|
| G0008 | Administration of influenza virus vaccine |
| G0009 | Administration of pneumococcal vaccine |
| G0010 | Administration of hepatitis b vaccine |
| M0201 | Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
The Medicare Claims Processing Manual (chapter 18, section 10.2.5.2) records that from January 1, 2022 the national payment rate for G0008, G0009 and G0010 was $30, adjusted by the geographic practice cost indices used in the physician fee schedule, and CMS publishes the current locality-adjusted administration rates on its vaccine pricing pages. M0201 is the additional payment when a vaccine is given in the patient's home, reported once per home per date of service. COVID-19 vaccine administration has its own code and rate, also listed on the CMS COVID-19 vaccine pricing page. The GPCI table shows the indices for each locality.
Coverage, cost sharing and who is paid what
Influenza, pneumococcal, hepatitis B and COVID-19 vaccines and their administration are covered under Part B in their own right, not as physician services. Part B pays 100% of the allowed amount: the deductible and coinsurance do not apply, the limiting charge does not apply, and every provider must accept assignment for the vaccine itself. Physicians, pharmacies and mass immunizers are paid the lower of their charge and the limit in this file; mass immunizers may submit roster bills listing many patients on one claim.
Institutional providers are paid differently for the vaccine, according to the Medicare Claims Processing Manual, chapter 18: hospitals, critical access hospitals, skilled nursing facilities and home health agencies at reasonable cost; Indian Health Service hospitals, hospices, comprehensive outpatient rehabilitation facilities and independent dialysis facilities at 95% of average wholesale price; and rural health clinics and federally qualified health centers at 95% of AWP from July 1, 2025, settled later through the cost report. Under OPPS the vaccines carry status indicator L, paid at reasonable cost and excluded from comprehensive APC packaging.
Common vaccine claim denials
Non-covered charge: Part B covers influenza, pneumococcal, hepatitis B and COVID-19 vaccines, while most other adult vaccines, such as shingles vaccines, are covered under Part D
Units above the date-of-service limit deny under the Medically Unlikely Edits; the MUE lookup answers that per code. Other Part B drugs and biologicals, including the pneumococcal and hepatitis B vaccines, are priced in the quarterly ASP pricing file rather than this seasonal file.
Where QuickIntell fits for vaccine claims
QuickRCM covers eligibility, claim readiness, denials, posting and A/R with configurable automation and human review, which is the stage where a vaccine line, its administration code and the NDC are checked against the season's file before submission.
Frequently asked questions
What does Medicare pay for a flu shot in 2026-2027?
The vaccine is paid at the payment allowance limit for its code in CMS's seasonal price file (for example $122.522 for 90662), plus a separate administration payment billed with G0008. Part B deductible and coinsurance do not apply.
When do the 2026-2027 vaccine prices take effect?
August 1, 2026 for most codes, through July 31, 2027. The file notes later start dates for some products, for example August 27, 2026 for the 2026-2027 COVID-19 vaccine codes.
Which code do I bill for a specific flu vaccine brand?
Use the NDC-HCPCS crosswalk for seasonal vaccines: it maps each product's NDC to its code, with 18 NDC rows this season. The table on this page lists the product name, labeler, NDC and billing units for every code.
Does Medicare Part B cover COVID-19 vaccines in 2026?
Yes. Influenza, pneumococcal, hepatitis B and COVID-19 vaccines and their administration are Part B benefits, paid at 100% of the allowed amount with no deductible or coinsurance; providers must accept assignment for the vaccine.
Other Medicare payment files are collected on the fee schedules hub. This page is replaced by the 2027-2028 season file when CMS publishes it.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- Seasonal influenza and COVID-19 vaccine payment allowance limits, 2026-2027Version 2026-2027 season (issued 2026-08-27) · effective 2026-08-01 · file Section 508 Version of 2026-2027 Seasonal Vaccine Price File (Issue Date 08_27_2026).csvSHA-256 98aff237bbb70135…
- NDC-HCPCS crosswalk for seasonal vaccines, 2026-2027Version 2026-2027 season (issued 2026-08-27) · effective 2026-08-01 · file Section 508 Version of 2026-2027 NDC-HCPCS Crosswalk for Seasonal Vaccines (Issue Date 08_27_2026).csvSHA-256 c812df7ce4020b4a…
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
Disclaimer
Operational reference compiled from the CMS seasonal vaccine files. Payment limits are Medicare Part B allowance limits per dose; institutional providers are paid on other bases. Vaccine codes are CPT numbers shown without descriptors (copyright AMA); product names are from the CMS crosswalk. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.