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MedicaidBilling CodesMedium impact

Influenza Vaccines Updates for Vaccines for Children

Missouri Medicaid (MO HealthNet)·MO · Family Medicine, Internal Medicine, Pediatrics·Provider Notice
Effective date
Sep 12, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

MO HealthNet Division made CPT code 90655 SL for influenza vaccine non-covered and introduced two new covered influenza vaccine codes (90688 SL and 90685 SL) through the Vaccines for Children program, both reimbursed at $5.00.

Action Required

Action needed
Billing team must stop using CPT code 90655 SL for influenza vaccines as it is non-covered. Update billing system to use CPT 90688 SL for quadrivalent influenza vaccines for patients 3+ years old and CPT 90685 SL for preservative-free vaccines for children 6-35 months old. Verify reimbursement rate of $5.00 for both codes in system. Update encounter forms to reflect new codes for VFC program patients.

Affected Billing Codes

90655
90688
90685