Pneumococcal Vaccine and Administration - JF Part B
Pneumococcal Vaccine and Administration
To learn more on billing pneumococcal, visit the Influenza and Pneumonia Billing webpage.
HCPCS/CPT Codes
- 90670 - Pneumococcal Conjugate vaccine, 13 valent (PCV13)
- 90671 - Pneumococcal Conjugate vaccine, 15 valent (PCV15)
- 90677 - Pneumococcal Conjugate vaccine, 20 valent (PCV20)
- 90732 - Pneumococcal polysaccharide vaccine, 23 valent (PPSV23)
- G0009 - Administration
Frequency
- Initial vaccine to beneficiaries who never received vaccine under Medicare Part B
- Different, second vaccine one year after first vaccine was administered
Diagnosis Code
Z23 - Encounter for immunization
Coverage
All Medicare beneficiaries are eligible
Payment
Copayment/coinsurance waived; Deductible waived
G0009 payment based on Locality-Adjusted Payment Rates
Noridian Medicare Portal
Yes. HCPCS codes 90670 and 90732 (Pneumococcal Vaccines) will display up to 10 previous dates of service and with the rendering NPI. These codes will only be viewable if the beneficiary has Medicare Part B coverage.
Resources
- Influenza and Pneumonia Billing
- CDC Pneumococcal Vaccine Timing for Adults
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 50.4.4.2
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 10
- CMS Medicare Learning Network (MLN) Publications
- CMS Medicare Preventive Services
- CMS Roster Billing for Mass Immunizers
- CMS Vaccine Pricing
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