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MedicaidBilling CodesMedium impact

c 213846

Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, Internal Medicine +1 more·Provider Bulletin
Effective date
Nov 30, 2015
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) now covers Trumenba and Bexsero meningococcal B vaccines through the VFC program for children under 19, with new CPT codes 90620 and 90621 for billing administration at $10.00 per dose. Coverage for beneficiaries 19+ will be limited starting November 30, 2015.

Action Required

Action needed
By November 30, 2015: Update billing system to use CPT 90620 for Bexsero vaccine administration and CPT 90621 for Trumenba vaccine administration (replacing CPT 90749). Set reimbursement rate at $10.00 per administration. Enroll in VFC program to obtain vaccines for patients under 19. After November 30, 2015, limit billing for beneficiaries 19+ to FDA-approved indications only.

Affected Billing Codes

90620
90621
90749