Vaccine Administration Codes

July 26, 2011

MaineCare covers vaccine administration codes

  • 90471 – Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections); one vaccine (single or combination vaccine/toxoid)

  • 90472 – Immunization administration (includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections)

The billable unit of service on the codes is one per vaccine, not one for each component of the vaccine. These codes can be used for pediatric and adult patients.

MaineCare does not cover the new pediatric codes

  • 90460 - immunization admin thru age 18 via any route with counseling first vaccine

  • 90461 - immunization admin thru age 18 via any route with counseling each additional.

These codes will not be added to contracts or covered. Claims denied for vaccine administration can be re-submitted.

Reminder: when billing for State supplied vaccines, use the SL modifier on the both the administration code and the vaccine code.

For questions about claims and billing, contact Provider Services at 1-866-690-5585.