Q2035 HCPCS code: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)
Q2035 is the HCPCS Level II code for influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria). In 2024 Medicare paid an average of $16.24 per service for Q2035 across 111 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume rose 10% from 2022 to 2024 (101 to 111 services). In 2024, about 12 clinicians billed Medicare for Q2035 for 111 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 54 |
| BETOS category | O1G — Immunizations/vaccinations |
| Added | 2011-01-01 |
| Last action effective | 2014-01-01 |
Who bills Q2035 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 12 |
| Medicare beneficiaries | 111 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q2035, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 101 | 100 | $16.55 | $16.55 |
| 2023 | 74 | 74 | $16.72 | $16.72 |
| 2024 | 111 | 111 | $16.24 | $16.24 |
States with the most Q2035 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 102 | $16.10 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (3,490 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| S00.01XA | Abrasion of scalp, initial encounter | 1 |
| S00.02XA | Blister (nonthermal) of scalp, initial encounter | 1 |
| S00.04XA | External constriction of part of scalp, initial encounter | 1 |
| S00.05XA | Superficial foreign body of scalp, initial encounter | 1 |
| S00.06XA | Insect bite (nonvenomous) of scalp, initial encounter | 1 |
| S00.07XA | Other superficial bite of scalp, initial encounter | 1 |
| S00.201A | Unspecified superficial injury of right eyelid and periocular area, initial encounter | 1 |
| S00.202A | Unspecified superficial injury of left eyelid and periocular area, initial encounter | 1 |
| S00.211A | Abrasion of right eyelid and periocular area, initial encounter | 1 |
| S00.212A | Abrasion of left eyelid and periocular area, initial encounter | 1 |
Showing 10 of 3,490. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for Q2035
- 2011-01-01: Q2035 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q2035?
Q2035 is the HCPCS Level II code for influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria). Short descriptor: "Afluria vacc, 3 yrs & >, im".
How much does Medicare pay for Q2035?
In 2024, the average Medicare payment was $16.24 per service (average allowed $16.24).
Does Medicare cover Q2035?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for Q2035?
Medicare policy articles that cite Q2035 list 3,490 covered ICD-10-CM diagnosis codes across 1 article. The most cited include S00.01XA (Abrasion of scalp, initial encounter), S00.02XA (Blister (nonthermal) of scalp, initial encounter), S00.04XA (External constriction of part of scalp, initial encounter). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of Q2035 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related Q20 codes
- Q2004 — Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml
- Q2009 — Injection, fosphenytoin, 50 mg phenytoin equivalent
- Q2017 — Injection, teniposide, 50 mg
- Q2026 — Injection, radiesse, 0.1 ml
- Q2028 — Injection, sculptra, 0.5 mg
- Q2034 — Influenza virus vaccine, split virus, for intramuscular use (agriflu)
- Q2036 — Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)
- Q2037 — Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)
- Q2038 — Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)
- Q2039 — Influenza virus vaccine, not otherwise specified
- Q2040 — Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
- Q2041 — Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
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Next steps
- Run a reimbursement report for a device billed under Q2035
- Watch Q2035 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q2035
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.