Summary
This bulletin obsoletes the August 26, 2022 adult vaccine bulletin, which listed an incorrect recommended age range for the shingles vaccine. Code 90750 for the zoster (shingles) vaccine now covers individuals 18 through 49 years of age who are immunodeficient or immunocompromised, in addition to the 50 through 120 age range already on the fee schedule. Codes 90587, 90626, 90627, 90671, 90677, 90750 and 90759 are billed for dates of service on and after August 29, 2022, per the attached Pennsylvania MA Program Fee Schedule, with a $10.00 MA fee each.
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What to do
Action · 7 steps
01Already effective August 29, 2022: Providers are to bill the adult vaccine administration codes 90587, 90626, 90627, 90671, 90677, 90750 and 90759 for MA fee-for-service claims, using the attached MA Program Fee Schedule, for dates of service on and after August 29, 2022.
02Use this bulletin rather than the August 26, 2022 adult vaccine bulletin, which this bulletin obsoletes.
03Bill each vaccine administration consistent with the indications for use of each vaccine as approved by the U.S. Food and Drug Administration and current Advisory Committee on Immunization Practices adult immunization schedules.
04Code 90750 covers individuals 18 through 49 years of age who are immunodeficient or immunocompromised, in addition to the 50 through 120 age range already on the fee schedule.
05Federally Qualified Health Centers and Rural Health Clinics are to refer to the billing instructions in this bulletin and in the MA Program's Provider Handbook and Billing Guides.
06Providers rendering services to MA beneficiaries in the managed care delivery system should contact the appropriate managed care organization with billing questions.
07Check current applicability of these codes and fees before billing them.
Codes mentioned
90587906269062790671906779075090759
Original notice
MAB2022091401
pa.gov · Always check the source before changing claims.
Related changes
See all Pennsylvania Medicaid (DHS) changes →MAB2022082603MediumEffective Aug 29, 2022 · Provider BulletinMAB2024012401MediumNo effective date · Provider BulletinMAB2024021301HighEffective Mar 1, 2024 · Provider BulletinMAB2022082602MediumEffective Aug 29, 2022 · Provider BulletinBrowse every Pennsylvania Medicaid (DHS) change in the policy list