If you provide pediatric vaccines in your practice, you have no doubt noticed the increase of combination vaccine products and a related decrease in your payment for vaccine administration services. The good news is that the CPT Editorial Panel and the Centers for Medicare & Medicaid Services (CMS) also noticed. New codes will allow reporting of the administration service for each vaccine component beginning in 2011. Even better, CMS published relative value units (RVUs) for these codes – even though they will not typically be reported for Medicare patients.
The new codes are 90460 and 90461. These codes should be reported for physician counseling (or that of another qualified health care professional) and administration of vaccines to children through age 18. Code 90460 is reported for administration of a single component vaccine and/or for the first component of a multiple component vaccine. Code 90461 is reported for each additional component of a multiple component vaccine. For example, MMR vaccine has three components, so administration of this vaccine would be reported with one unit of 90460 and two units of 90461.
CMS assigned RVUs to these codes by crosswalking them with the values of the adult vaccine administration codes 90471 and 90472. This means that new code 90460 has the same RVUs as 90471, and each unit of 90461 has the same RVUs as 90472. Beats getting one administration fee that was valued the same as 90471!
AAFP Coding Resources web pages have been updated to provide more information on these new codes and the guidelines for reporting them.
More to come on CPT code changes for 2011 in your January/February issue of Family Practice Management!
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