Traditional MedicareReimbursementMedium impact
2026-09-10 - COVID-19 Vaccine: Updated Pricing for 2026–2027 Season
Medicare/CMS·Allergy & Immunology, Family Medicine, Internal Medicine +2 more·Coding
We identified it
Sep 29, 2026
Summary
CMS has updated COVID-19 vaccine payment allowances for the 2026–2027 season, affecting six CPT codes (91304, 91319, 91320, 91321, 91322, 91323). Billing teams must verify updated payment rates and ensure claims are submitted with correct codes and corresponding National Drug Codes for accurate reimbursement.
Action Required
Billing team must access the CMS Vaccine Pricing webpage to obtain the updated payment allowances and effective dates for CPT codes 91304, 91319, 91320, 91321, 91322, and 91323. Download the vaccine crosswalk (ZIP) file to identify corresponding National Drug Codes. Update billing system fee schedules and claims submission rules with new payment rates before the effective date. Verify that all COVID-19 vaccine claims submitted going forward use the correct CPT codes matched to their National Drug Codes. Failure to update rates may result in claim denials or underpayment.