HCPCS/CPT Codes
- 90670 – Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use
- 90732 – Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
- G0009 – Pneumococcal Administration
ICD-10 Codes
The specified below ICD codes are covered for CPT G0102 and G0103 but may not be limited and some private payers having specific guidelines.
- Z23 Encounter for immunization
- Z71.84 Encounter for health counseling related to travel
Who Is Covered
- All Medicare beneficiaries
Fee Value and MUE Edits
CPT Dosage Fee MUE
90670 0.5 ml $241.383 1
90732 0.5 ml $125.918 1
90670 0.5 ml $241.383 1
90732 0.5 ml $125.918 1
Frequency
- An initial pneumococcal vaccine to Medicare beneficiaries who never received the vaccine under Medicare Part B
- A different, second pneumococcal vaccine 1 year after the first vaccine was administered
Medicare Beneficiary Pays
- Co-payment/coinsurance waived
- Deductible waived
