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PA Bulletin, Doc. No. 16-2210


Medical Assistance Program Fee Schedule; Addition of Procedure Code for Vaccine Administration

[46 Pa.B. 7904]
[Saturday, December 17, 2016]

 In accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Human Services (Department) announces the addition of the following procedure code to the Medical Assistance (MA) Program Fee Schedule for the administration of a cell culture influenza vaccine, quadrivalent, effective for dates of service on and after January 1, 2017.

Procedure Code Description MA Fee
90674 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use $10

 The United States Food and Drug Administration approved use of Flucelvax Quadrivalent®, a quadrivalent influenza virus vaccine derived from cell cultures, on May 23, 2016. The Department is adding Current Procedural Terminology (CPT) code 90674 to the MA Program Fee Schedule to identify when a practitioner administers Flucelvax Quadrivalent®.

 CPT code 90674 is part of the Centers for Medicare & Medicaid Services annual 2017 Healthcare Current Procedure Coding System update to be implemented on January 1, 2017.

 The Department will issue an MA Bulletin to providers enrolled in the MA Program specifying the procedures for billing of the administration of the vaccine.

Fiscal Impact

 The Department anticipates no fiscal impact as a result of adding procedure code 90674 to the MA Fee Schedule, as there is an existing procedure code on the fee schedule that is being used for the administration of an unspecified vaccine and the addition of this procedure code will not increase utilization.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revision to the MA Program Fee Schedule.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).


Fiscal Note: 14-NOT-1107. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 16-2210. Filed for public inspection December 16, 2016, 9:00 a.m.]

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