Flu Vaccine

Gateway Health Plan^® and Vaccines for Children (VFC) both follow the Center for Disease Center (CMC) approved guidelines for Pediatrics in the administration of the flu vaccine, which include high risk children and children the ages of 6-23 months. The administration fee is included in the reimbursement for the vaccine.

The following codes are reimbursed by Gateway Health Plan^® for the flu vaccine at $14.65:

• 90655-Influenza virus vaccine, split virus, preservation free, 6-35 months dosage, for intramuscular or jet injection use.
• 90656-Influenza virus vaccine, split virus, preservation free, 3 years and above, for intramuscular or jet injection use.
• 90657-Influenza virus vaccine, split virus, 6-35 months dosage, for intramuscular or jet injection use.
• 90658-Influenza virus vaccine, split virus, 3 years of age or above, for intramuscular or jet injection use.
• 90659-Influenza virus vaccine, whole virus for intramuscular or jet injection use for children and adults.

The 90660 Nasal Flu vaccine is reimbursed at $23.91 for members age 2-49. Providers should follow CDC recommendations for use of this vaccine.

Children under 9 years old should get two doses the first year they receive the flu vaccine. Gateway will now pay an administration fee for both doses.

If you have any questions/concerns please contact Provider Services at 1-800-392-1145 or contact your Provider Relations Representative.