Originally published September 28, 2017. Part B now also covers COVID-19 vaccines, and Part D vaccine cost-sharing changed in 2023. Payer rules change; confirm current CMS and payer requirements before billing.
Medicare Part B covers three routine immunizations:
- Pneumococcal pneumonia
- Influenza
- Hepatitis B, for patients at medium to high risk
Other vaccines are covered under Medicare Part D. Part B covers other immunizations only after exposure to a dangerous disease. For example, it covers a tetanus shot after stepping on a rusty nail, or rabies shots after a dog bite.
See the CMS Medicare immunization billing guide.
Immunization after exposure
- Hepatitis A: 90632, 90633, 90634
- Immune globulin, subject to LCD L30147
- Rabies prophylaxis: 90675, 90676
- Tetanus and diphtheria toxoids: 90702, 90714, 90715
Tetanus
Covered when given for an acute injury to a patient who is not fully immunized.
- 90702
- Diphtheria and tetanus toxoids (DT)
- 90714
- Tetanus and diphtheria toxoids (Td), 7 years or older
- 90715
- Tetanus, diphtheria and acellular pertussis (Tdap), 7 years or older
Rabies
Rabies is carried by animals and spread by a bite or scratch. When giving a rabies vaccine after contact with a high-risk animal, bill 90675 with the ICD-10 code for the exposure.
- 90675
- Rabies vaccine, intramuscular
- 90676
- Rabies vaccine, intradermal