Medicare now covers the 20-valent pneumococcal conjugate vaccine
Medicare began covering the new 20-valent pneumococcal conjugate vaccine on Oct. 1.
The Centers for Medicare & Medicaid Services suggests submitting separate claims for this vaccine using CPT code 90677, “Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use.” Don’t forget to also report the appropriate CPT code for administration of the vaccine.
Part B Medicare administrative contractors began processing these claims on Oct. 4, and will deny claims for shots given July 1–Sept. 30 (before the vaccine was covered by Medicare).
— Kent Moore, Senior Strategist for Physician Payment
Posted on Oct. 14, 2021 by Kent Moore
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Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.