New Current Procedural Terminology (CPT) codes designed to capture immunization counseling and multi-vaccine administration have been released, reflecting advancements in patient monitoring and vaccine delivery, but thier impact hinges on payer coverage. The American Academy of Family Physicians (AAFP) highlighted potential benefits of the codes, particularly for counseling related to immunizations when the vaccine isn’t administered at the same visit, but expressed concern over proposed Medicare non-coverage.
these coding updates aim to more accurately represent the work of healthcare professionals in a rapidly evolving landscape of vaccine recommendations and patient education needs.While one new code will allow for reporting of each additional non-COVID-19 vaccine component given alongside a COVID-19 vaccine, it’s primarily intended as a tracking mechanism. The more significant impact is expected from codes covering immunization counseling, but their utility will be limited if not reimbursed, according to the AAFP.
“The new codes for immunization counseling in the absence of immunization administration could be impactful if payers cover and pay for them,” the AAFP representative stated. “Unfortunately, CMS has proposed not to pay for them under Medicare.”
The AAFP also noted the new code for reporting additional vaccine components administered with the COVID-19 vaccine is “effectively only a tracking code” and isn’t anticipated to significantly alter billing practices.
