In consultation with HHS, the AMA CPT Editorial Panel are utilizing two codes for H1N1:
- Code 90470 to report H1N1 immunization administration and counseling;
- Code 90663 was revised by the CPT Editorial Panel to refer specifically to the H1N1 vaccine product.
Both revised code 90663 and 90470 are effective immediately. For more H1N1 information, see http://www.ama-assn.org/go/h1n1.
In addition, CMS has developed two new codes for H1N1 immunizations for the Medicare program:
- G9141—Influenza A (H1N1) immunization administration (includes physician counseling the patient/family);
- G9142—Influenza A (H1N1) vaccine, any route of administration.
CMS says the H1N1 vaccine will be provided free of charge to immunizers. For H1N1 vaccine administration, Medicare will pay the same rate as it does for administering seasonal flu vaccine, about $21. In addition, for both seasonal flu and H1N1 vaccine administration, Medicare will pay 100%, and patients will not be charged any co-pays or deductibles. Federal HHS has also asked private insurers to provide first-dollar coverage of H1N1 vaccine administration.