Physicians/Specialists
Facilities/Hospitals
Ancillary
Publication Date: 
2020-09-09

9/29/2020 Update: Addition of information for FEP members


Many Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members are eligible to receive a flu shot at no cost. Providers should check members' preventive care benefits to see if they qualify and if any applicable copayments, deductibles, or coinsurance amounts apply.

Eligible Blue Cross NC commercial members (both individual and group) can receive their seasonal flu shots at the following locations:

  • Physicians' offices
  • Immunizing pharmacists
  • In-network pharmacies (member must have Prime as their pharmacy benefit manager)
  • Immunizing health departments
  • Minute Clinics
  • Employers' worksite flu shot clinics (if applicable)

For additional details about the 2020-2021 Blue Cross NC seasonal flu program for commercial members, please see What's True About the Flu.

The following vaccines are available for the 2020-2021 flu season:

Flu Vaccine CPT Codes Notes
Flu vaccine (trivalent)
  • CPT 90653 - intramuscular ages 65+
Combo vaccine with two strains of influenza + H1N1
Flu vaccine or FluMist (quadrivalent)
  • CPT 90662 - high dose for 65+
     
  • CPT 90672 - intranasal, ages 2 - 49

    NOTE: The Advisory Committee on Immunization Practices determined that FluMist (LAIV4) can be used during the 2020 - 2021 season.
     

  • CPT 90674 - intramuscular, ages 4+
     
  • CPT 90682 - intramuscular age 18+
     
  • CPT 90685 and 90687 - intramuscular, ages 6 - 35 months
     
  • CPT 90686 and 90688 - intramuscular, ages 6 months and up
     
  • CPT 90694 - Fluad Quadrivalent
     
  • 90756 - intramuscular ages 4+
     
  • Q2035 - intramuscular ages 5+
Combo vaccine with three strains of influenza + H1N1

Administrative Codes for Flu Vaccine

Patients CPT Codes

Any age patient with counseling

90460-90461
Any age patient when no counseling is involved 90471-90474
Patients who also have Medicare coverage G0008 (Medicare requires this code for influenza)

For Blue Medicare Members

Blue MedicareSM HMO and Blue MedicareSM PPO members are eligible to receive flu shots without a copayment if they go to in-network doctors for their flu shots. However, if a patient sees the doctor for other services, an office visit copayment may be charged. Blue Medicare patients can also receive their annual flu shots at any in-network immunizing pharmacist.

Providers may access the Quick Reference Medicare Immunization Billing guide for complete details about immunization procedure codes and descriptors for Blue Medicare members. Please review the Blue Medicare flu shot web page for specific details.

For Federal Employee Program (FEP) Members

There are many places FEP members can go at their convenience to get a flu shot, including their local pharmacy. Per the Blue Cross and Blue Shield Service Benefit Plan, FEP members can receive a flu shot with no out-of-pocket cost at a Preferred provider or at any of our Preferred retail pharmacies in our FEP network. Members should check with their pharmacy or call 1-800-624-5060 to find out which vaccines their local pharmacy can provide. Visit the FEP website for more information.