Claims Processing Instructions for the New Pneumococcal 15-valent Conjugate Vaccine Code 90671 and Pneumococcal 20-valent Conjugate Vaccine Code 90677

Published 03/30/2022

In this Article, you’ll learn about: a new code for a pneumococcal vaccine; where to find pricing for the code; and the basis for Medicare’s payment to institutional providers for this code. Make sure your billing staff knows about new vaccine code: CPT code 90677, which is effective for Dates of Service (DOS) on or after July 1, 2021 and CPT code 90671, which is effective for DOS on or after July 16, 2021.

CMS revised this article due to a revised Change Request (CR) 12439. The revised CR shows the MACs will adjust certain previously processed and rejected claims with CPT code 90671 after April 4, 2022. CMS made the same change in the article in dark red font on page 2.