It is a common misconception that the administration fee for the injection of vaccines and toxoids should be charged per injection site. The proper method is to charge an administration fee for each component of a vaccine or toxoid. With the high costs of medication, it is important for any physician practice to ensure its costs are covered and that revenue opportunities are not lost. As such, the following serves as a guide for the proper billing of the administration of vaccines and toxoids.
The applicable CPT codes are as follows:
One component of a vaccine or toxoid would be charged the 90460 administration fee only. Examples include the vaccine for HPV, Influenza, Pneumococcal, Rotavirus, IPV, Hib or Meningococcal, just to name a few.
The following is an example of a circumstance where multiple components of a vaccine or toxoid would be charged: A five-year old receives a DTaP-IPV IM administration and an MMR/Varicella vaccine SQ administration. The charges on the claim would be:
It is very important to know which vaccines and toxoids are comprised of multiple components so that you can bill for the administration of those vaccines and toxoids properly. If you are unsure, Precision is here to help you. Please feel free to contact us.