Pediatric/adolescent hepatitis B vaccine, three-dose series, intramuscular administration

Description

This code pertains to the administration of a three-dose hepatitis B vaccine specifically designed for pediatric and adolescent patients. The vaccine is given via intramuscular injection to provide protection against hepatitis B, a serious liver disease.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Medicare Ambulatory Surgical Center Reimbursement (ASC)

ASC Payment Rate

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Patient Copayment / Coinsurance

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Standard copayment (20%):—

Top Modifiers

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HCPCS/CPT SLState-supplied vaccine modifier(3.05%)

HCPCS/CPT JZZero drug amount discarded or not administered(1.53%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(1.53%)

HCPCS/CPT X1Continuous patient care services without planned endpoint(0.76%)

HCPCS/CPT U1Medicaid level of care 1 designation(0.76%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(0.76%)

HCPCS/CPT 25Significant, separately identifiable evaluation and management service on the same day(0.76%)

HCPCS/CPT CRCatastrophe or disaster-related service modifier(0.76%)

HCPCS/CPT CCProcedure code change due to administrative or filing error(0.76%)

HCPCS/CPT GCServices performed by a resident under the supervision of a teaching physician(0.76%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)