Tdap administration form 2025

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90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for intramuscular use 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use 90716 Varicella virus vaccine
For Medicaid fee for service processing, to ensure proper reimbursement when more than six vaccines are administered on a single date, providers should bill the 90471 as the primary procedure, 90472 with five units on one claim line, and any additional injections with 90472 on a separate claim line.
CPT code 90651 is used to identify the administration of the human papillomavirus (HPV) vaccine, specifically the 9-valent HPV vaccine, which is given either as a two-dose or three-dose series via intramuscular injection.
Tetanus and Diphtheria Vaccinations Billing Guidelines CPT CodeDescription 90714 Tetanus and diphtheria toxoids (Td) older than age 7 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) 90471 Immunization administration 90472 Immunization administration Dec 9, 2023
The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered. The name, office address, title and signature (electronic is acceptable) of the person administering the vaccine. The Vaccine Information Statement (VIS) edition date located in the lower right corner on the back of the VIS.
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