Medicare Now Pays for Vaccine Counseling

A set of new CPT codes recognizes the counseling work involved in administering injectable child and adolescent immunizations.

In the 2005 Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services (CMS) assigns work values to four injectable vaccine codes. Two (90465 and 90466) are new codes for vaccine injections for children under the age of 8 years; the other two (90471 and 90472) are existing codes.

Previously, codes for vaccine administration did not include the relative value for physician work. Counseling work now is bundled into each of these codes with the administration of the vaccine.

For a detailed explanation of how to use these and related codes, including additional new codes 90467 and 90468 for administration of internasal or oral vaccines for children under the age of 8, read this comprehensive overview from the American Academy of Pediatrics.

CMS also increased the practice expense component in all injection codes in the 2005 Medicare Physician Fee Schedule.


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