Medicare covers flu, pneumococcal, and Hepatitis B shots. Flu, pneumococcal infections, and Hepatitis B can be life threatening to an older person. This is especially important for those who have chronic illness, including heart disease, lung disease, diabetes, or End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). People at medium to high risk for Hepatitis B should get Hepatitis B shots.

Who Is Covered

Medicare covers the hepatitis B vaccine for certain beneficiaries who are at intermediate to high risk for the hepatitis B virus (HBV). These individuals include health care professionals who have frequent contact with blood or blood-derived body fluids during routine work, those with End-Stage Renal Disease (ESRD), persons who live in the same household as an HBV carrier, and persons diagnosed with diabetes mellitus. Other situations could qualify a beneficiary as being at intermediate or high risk of contracting HBV.

Note: Medicare beneficiaries who are currently positive for antibodies for hepatitis B are NOT eligible for this benefit

HCPCS/CPT Codes

90739 - Hepatitis B vaccine, adult dosage (2 dose schedule), for intramuscular use

90740 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use

90743 - Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use

90744 - Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use

90746 - Hepatitis B vaccine, adult dosage (3 dose schedule), for intramuscular use

90747 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use

G0010 - Administration of Hepatitis B vaccine

ICD-10-CM Codes

Z23

Frequency

Medicare Part B (Medical Insurance) normally covers one flu shot per flu season.

Scheduled dosages required

Medicare Beneficiary Pays

You pay nothing for a flu shot if the doctor or other qualified health care provider accepts assignment for giving the shot.

   • Copayment waived

   • Coinsurance waived

   • Deductible waived

References