MedicaidBilling CodesMedium impact
Newsletter Vol. 21, No.10
New Jersey Medicaid·NJ · Family Medicine, Pediatrics, General Practice·Coding
Effective date
Jul 1, 2011
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is retiring CPT codes 90465-90468 for vaccine administration and requiring use of CPT codes 90471-90474 for NJ-VFC immunization administration starting July 1, 2011. The policy specifies enhanced reimbursement rates for each administration code.
Action Required
By July 1, 2011: Billing team must stop using CPT codes 90465, 90466, 90467, and 90468 for vaccine administration. Update billing system to use CPT 90471 ($16.18) and 90472 ($11.50) for injections, and CPT 90473 ($12.12) and 90474 ($8.43) for intranasal/oral vaccines for children under 19. Ensure both vaccine administration code and immunization CPT code are reported with same date of service to avoid Error Code 778 denials.