MedicaidBilling CodesMedium impact
MAB2022032101
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, General Practice +1 more·Provider Bulletin
Effective date
Jun 1, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) added two new vaccine administration CPT codes effective June 1, 2021: CPT 90619 for MenQuadfi® meningococcal vaccine ($10 fee) and CPT 90697 for Vaxelis® combination vaccine ($10 fee). These vaccines are now available through the VFC program for eligible children under 19.
Action Required
Immediately: Update billing system to include CPT codes 90619 (MenQuadfi vaccine) and 90697 (Vaxelis vaccine) with $10.00 administration fee for Pennsylvania Medicaid patients. Verify patient age eligibility: 90619 for ages 2+ years, 90697 for 6 weeks through 4 years. Train staff on VFC program availability for eligible children under 19. Update encounter forms to include new vaccine codes.