CPT 90661 Medicare ASP Payment Limit 2026
Medicare's Part B payment limit for CPT 90661 is $66.57 per billing unit (1 dose) in the October 2026 ASP file, up 34.5% from $49.50 in 2025.
- Per 1 dose
- $66.57
- vs. 2025
- +34.5%
- Commercial national avg.
- $38.75
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| Code | Month | Year | Payment Limit | Description |
|---|---|---|---|---|
| 90661 - CPT | Jan | 2025 | $36.85 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Apr | 2025 | $36.85 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Jul | 2025 | $36.85 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Oct | 2025 | $49.50 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Jan | 2026 | $49.50 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Apr | 2026 | $49.50 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Jul | 2026 | $49.50 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
| 90661 - CPT | Oct | 2026 | $66.57 | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use |
90661 payment limit by quarter
Each row is one quarterly CMS ASP file. Change is against the quarter before.
| Quarter | Payment limit per 1 dose | Change |
|---|---|---|
| October 2026 | $66.57 | +34.5% |
| July 2026 | $49.50 | No change |
| April 2026 | $49.50 | No change |
| January 2026 | $49.50 | No change |
| October 2025 | $49.50 | +34.3% |
| July 2025 | $36.85 | No change |
| April 2025 | $36.85 | No change |
| January 2025 | $36.85 | - |
The payment limit is Medicare's allowed amount per billing unit: the average sales price plus the statutory add-on. Medicare generally pays 80% of it after the Part B deductible, and the patient's coinsurance covers the rest. CMS recalculates it every quarter from manufacturer-reported sales.
90661: Medicare vs. commercial national average
The commercial national average for 90661, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $38.75 per 1 dose, 58% of Medicare's $66.57.
- BCBS $35.51
- UnitedHealthcare $36.31
- Aetna $41.22
- Cigna $41.96
A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 90661 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its current ASP payment limit per billing unit. Payers may bill the drug in a different unit, so compare the two with care.
Nearby codes
Compare Medicare's rate for 90661 with published commercial rates
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See what state Medicaid programs pay for 90661
50 state Medicaid agencies publish their own physician fee schedule. The 90661 page shows real published rates for several of them free, with effective dates and official sources.
17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.
Related codes
Methodology
Rates are sourced from CMS Part B Drug Average Sales Price (ASP) pricing files, published quarterly. Each HCPCS payment limit reflects the calculated ASP plus the statutory add-on for that quarter.
View CMS Part B ASP Pricing Files