2025 CPT code 90473
(Active) Effective Date: N/A Medicine Services and Procedures - Immunization Administration for Vaccines/Toxoids Medicine Feed
Immunization administration by intranasal or oral route; one vaccine (single or combination vaccine/toxoid).
Modifiers may be applicable in certain circumstances.For example, modifier 52 may be used for reduced services, or modifier 79 for an unrelated procedure or service.
Medical necessity for the specific vaccine administered should be documented based on the patient's age, health status, risk factors, and recommended immunization schedules.
The physician or other qualified healthcare professional prepares the vaccine and administers it to the patient via the intranasal or oral route. This includes ensuring appropriate patient preparation and post-immunization care, as well as documentation of the vaccine administered.
In simple words: This code covers giving the first dose of a vaccine by nose or mouth.
This code represents the administration of a single vaccine (or combination vaccine/toxoid) via the intranasal or oral route.It is used for the first vaccine administered in this manner during a single encounter. Subsequent intranasal or oral vaccine administrations during the same encounter should be reported using code 90474.
Example 1: A 6-month-old infant receives the first dose of the rotavirus vaccine orally., A 2-year-old child receives the first dose of the influenza vaccine via the intranasal route., A 5-year-old child receives a combination vaccine containing both a live attenuated intranasal influenza vaccine and an oral poliovirus vaccine. In this case, 90473 is reported once for the combination.
Documentation should include the date of service, vaccine administered (including name, manufacturer, lot number, and dosage), route of administration (intranasal or oral), site of administration for intranasal vaccines (if applicable), and any adverse reactions.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Family Medicine, Pediatrics, Internal Medicine, Public Health
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Public Health Clinic and other places of service where vaccinations are performed.