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).

Who Is Covered

All Medicare beneficiaries

HCPCS/CPT Codes

90669 - Pneumococcal conjugate vaccine, polyvalent, when administered to children younger than 5 years, for intramuscular use

90670 - Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use

90732 - Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use

G0009 - Administration - Pneumococcal

ICD-10-CM Codes

Z23

Frequency

An initial pneumococcal vaccine to Medicare beneficiaries who never received the vaccine under Medicare Part B; and

A different, second pneumococcal vaccine 1 year after the first vaccine was administered

Medicare Beneficiary Pays

You pay nothing for pneumococcal shots if your doctor or other qualified health care provider accepts assignment.

   • Copayment waived

   • Coinsurance waived

   • Deductible waived

References