Vaccine products and immunization administrations identified with separate Current Procedural Terminology (CPT®) codes are reported separately when performed at the same encounter as a preventive medicine service. This is clearly stipulated in the introductory language of the Preventive Medicine Services section (99381–99397) of the CPT manual. Unfortunately, the American Academy of Pediatrics (AAP) and pediatric practices must continue to advocate and negotiate for separate payment for immunization ad-ministration codes because some payers continue to consider these services as inherent to the preventive medicine service codes.

Practices should be aware that when the new immunization administration codes are effective, up to 4 units each of codes 90460 and 90461 may be reported at the 2-, 4-, and 6-month preventive medicine visits. As a result, the total Medicare Resource-Based Relative Value Scale values for immunization administration may exceed the value valuation and time of the preventive medicine service....

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