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US · guidance

CMS Pub. 100-04, ch. 18, § 10.1.2

Influenza Virus Vaccine

activein force · 2026-08-25 – presentas-observed

Effective for services furnished on or after May 1, 1993, the influenza virus vaccine and its

administration is covered when furnished in compliance with any applicable State law.

Typically, this vaccine is administered once a flu season. Medicare does not require for

coverage purposes that a doctor of medicine or osteopathy order the vaccine. Therefore, the

beneficiary may receive the vaccine upon request without a physician’s order and without

physician supervision. Since there is no yearly limit, A/B MACs (A) and (B) determine

whether such services are reasonable and allow payment if appropriate.

See Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 50.4.4.2 for

additional coverage requirements for influenza virus vaccine.

History

(Rev. 2253, Issued: 07-08-11, Effective: 08-08-11, Implementation: 08-08-11)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
35dd7052b8fe33bf94ac6497a8f9c11672ae7d5febe5e11a3f812caae3ef970f
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