High-dose Influenza Vaccine Guidelines

Getting the flu vaccine is the best way to prevent the spread of the flu. Therefore, we encourage our members and communities to invest in their health and get vaccinated. We also want to ensure members are receiving the appropriate vaccine for their age according to the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) . We are here to help you give your patients and our members the best care possible. As a reminder, the flu vaccines called “High-dose influenza” are only approved by the FDA for those 65 and older. These included Fluzone High-Dose and FLUAD for the 2017-2018 flu season, but new products could become available each year. During flu season, please refer to the “Table of Approved Vaccines” on the CDC website for the most recent updates.

When a flu vaccine is administered to members outside of the approved age range, your patients are not receiving the most effective or appropriate care and their health care dollars are not being used in the most economical way. Please be aware of correct vaccine administration as well as accurate coding when filing your claims.

Details on our complete, approved immunization schedule can be found on the BCBSTX Provider website under Standards & Requirements, Clinical Payment and Coding Policies, “Preventive Services Policy CPCP006” .