Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Outpatient hospital: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Medicare pricing for M0201
Physician Fee Schedule (CY 2026, RVU26D)
Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for M0201
Payer coverage policies that name M0201
M0201 appears in 2 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.