11/1/2018
•
Posted by Provider Relations
Effective December 1, 2018, Fidelis Care is making changes to Medicaid and Child Health Plus vaccine codes regarding age limitations and removal of the authorization requirement.
For outpatient place of service (physician or facility claims), please note the following changes:
|
CPT Code
|
Description
|
Authorization
Change
|
Age Limitations Change (added limits)
|
|
90625
|
Cholera vaccine, live, adult dosage
|
No authorization is required
|
Normal age 18 – 64 y/o
|
|
90690
|
Typhoid vaccine, live, oral
|
Normal age > 6 y/o
|
|
90691
|
Typhoid vaccine, IM
|
Normal age > 2 y/o
|
|
90717
|
Yellow fever vaccine, live, SC
|
No age limits
|
|
90750
|
Zoster (shingles) vaccine, (HZV), recombinant, subunit, adjuvanted. Shingrix
|
Normal age > 50 y/o
|
For a complete list of the vaccine guidelines, please download Coverage of Vaccines – Medicaid and Child Health Plus Members