2025 CPT code 90460
(Active) Effective Date: N/A Revision Date: N/A Medicine Services and Procedures - Immunization Administration for Vaccines/Toxoids Medicine Feed
Immunization administration for patients up to 18 years old, involving face-to-face counseling by a physician or qualified professional; for the first or only vaccine/toxoid component.
Modifiers may be applicable depending on the circumstances of service.Consult the CPT manual and your payer's guidelines.
Medical necessity is established by the patient's age and the recommended immunization schedule outlined by the Centers for Disease Control and Prevention (CDC) or the Advisory Committee on Immunization Practices (ACIP).Documentation of the patient's risk factors for vaccine-preventable diseases might be needed depending on the payer.
The physician or other qualified healthcare professional administers the vaccine and provides pre- and post-immunization counseling to the patient or their guardian.
In simple words: This code covers giving a vaccine to a child or teen (under 18) along with the doctor or nurse talking with the parent or child about the shot, how to take care of them afterward, and any possible side effects.
This CPT code, 90460, encompasses the administration of a single vaccine or toxoid component to a patient under 18 years of age.It includes the provision of face-to-face counseling by a physician or qualified healthcare professional regarding the vaccine, its administration, and post-immunization instructions and precautions. This counseling is a crucial element of the procedure, and the code should only be reported when such counseling is provided.The administration can be via any route (parenteral, oral, intranasal, intramuscular, or intravenous).For additional vaccines or toxoid components administered to the same patient during the same encounter, code 90461 should be reported separately in addition to code 90460.
Example 1: A pediatrician administers a measles, mumps, and rubella (MMR) vaccine to a 12-month-old child. The pediatrician counsels the parents on the vaccine's benefits, potential side effects, and the importance of the second dose., A family physician administers the first dose of the varicella vaccine to a 15-month-old and counsels the parents on the typical reactions and the need for the second dose at a later date., In a public health clinic, a nurse practitioner administers a flu vaccine to a 17-year-old patient and provides counseling regarding the importance of annual vaccination and potential side effects, such as soreness at the injection site.
Documentation must include: patient's age; vaccine administered (including manufacturer and lot number); route of administration; date of administration; details of counseling provided; and physician or qualified healthcare professional's signature.
** This code is only for the first or only vaccine component.Additional components require the use of code 90461.This code should not be used for COVID-19 vaccinations.
- Revenue Code: O1G (Influenza Immunization - example, may vary based on payer and specific vaccine)
- RVU: RVUs vary based on geographic location and payer. Consult your local fee schedule.
- Global Days: Not applicable. This is a single-service code.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a complete procedure code.
- Fee Schedule: Historical fee schedule data varies by payer and geographic location. Check your payer's historical fee schedules.
- Specialties:Pediatrics, Family Medicine, Internal Medicine, Public Health
- Place of Service:Office, Clinic, Hospital, Public Health Clinic