Immunization and Vaccine Benefits Codes for Children
The following tables list vaccines and toxoids that can be acquired (pending availability) through the Minnesota Vaccines for Children (MnVFC) program for children ages 0-18 years. Providers cannot bill Minnesota Health Care Programs (MHCP) for vaccines supplied by MnVFC but can bill for the vaccine administration.
Seasonal Respiratory Illness Vaccines
Follow Billing for Child Vaccines protocol under the Immunizations and Vaccinations section in the MHCP Provider Manual for these vaccines.
Centers for Disease Control and Prevention guidance: TABLE. Influenza vaccines — United States, 2021–22 influenza season*
CPT Code | Description | Ages |
90380 | Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use | 0 - 24 months |
90381 | Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use | 0 - 24 months |
90672 | FluMist (LAIV4) | 2 - 18 years |
90674 | Flucelvax (ccIIV4) | 6 months and older |
90756 | Flucelvax (ccIIV4) | 6 months and older* |
90682 | Flublok (RIV4) | 18 years* |
90685 | Afluria (IIV4) | 6 months and older* |
90686 | Fluarix (IIV4); FluLaval (IIV4); Fluzone (IIV4) | 6 months - 18 years |
90686 | Afluria (IIV4) | 3 - 18 years |
90687 | Fluzone (IIV4); Afluria (IIV4) | 6 months - 3 years |
90688 | Fluzone (IIV4); Afluria (IIV4) | 3 - 18 years |
90756 | Flucelvax (ccIIV4) | 6 months and older* |
* Not available through MnVFC
Vaccines and Toxoids Available Through MnVFC
Follow Billing for Child Vaccines protocol under the Immunizations and Vaccinations section in the MHCP Provider Manual for these vaccines.
CPT Code | Description | Ages |
90619 | MenQuadfi Meningococcal polysaccharide (groups A, C, Y, W-135) TT conjugate | 2 - 18 years |
90620 | Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), 2 dose schedule | 10 - 18 years |
90621 | Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule | 10 - 18 years |
90622 | Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use | 12 months and older |
90633 | Hepatitis A vaccine (HepA), 2 dose schedule | 6 months -18 years |
90636 | Hepatitis A and hepatitis B vaccine (HepA-HepB) | 18 years |
90647 | Haemophilus influenza type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule | 6 weeks - 5 years |
90648 | Haemophilus influenza type b vaccine (Hib), PRP-T conjugate, 4 dose schedule. | 6 weeks - 5 years |
90651 | Human Papillomavirus vaccine types 6, 1, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 2 or 3 dose schedule | 9 -18 years |
90670 | Pneumococcal conjugate vaccine, 13 valent (PCV13) | 6 weeks - 18 years |
90671 | Pneumococcal conjugate vaccine, 15 valent (PCV15) | 6 weeks - 18 years |
90672 | Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use | 2 - 18 years |
90674 | Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use | 6 months and older |
90677 | Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use | 2 months and older |
90680 | Rotavirus vaccine, pentavalent (RV5), 3 dose schedule | 6 weeks - 1 year |
90681 | Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule | 6 weeks - 1 year |
90686 | Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use | 6 months - 18 years |
90687 | Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use | 6 months - 3 years |
90688 | Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use | 3 - 18 years |
90696 | Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV) | 4 - 6 years |
90697 | Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenza type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), 3 dose schedule | 6 weeks - 4 years |
90698 | Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenza type b, and inactivated poliovirus vaccine (DTaP-IPV/Hib) | 6 weeks - 4 years |
90700 | Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP) | 6 weeks - 7 years |
90702 | Diphtheria and tetanus toxoids adsorbed (DT) | 6 weeks - 7 years |
90707 | Measles, mumps and rubella virus vaccine (MMR) | 1 - 18 years |
90710 | Measles, mumps, rubella, and varicella vaccine (MMRV) | 1 - 12 years |
90713 | Poliovirus vaccine, inactivated (IPV) | 6 weeks - 18 years |
90714 | Tetanus and diphtheria toxoids adsorbed (Td) | 7 - 18 years |
90715 | Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) | 7 - 18 years |
90716 | Varicella virus vaccine (VAR), live | 1 - 18 years |
90723 | Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV) | 6 weeks - 6 years |
90732 | Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage | 2 - 18 years |
90734 | Meningococcal conjugate vaccine, serogroups A, C, Y and W-135, quadrivalent (MCV4 ir MenACWY) | 2 months - 18 years |
90744 | Hepatitis B vaccine (HepB), 3 dose schedule | 6 weeks - 18 years |
COVID-19 Vaccines
CPT Code | Description | Ages | Effective Date |
91304 | SARS-CoV-2 VAC 5MCG/0.5ml IM Novavax COVID-19 Vaccine | 12 years and older | July 13, 2022 |
91318 | SARSCOV2 VACC 3MCG/0.3ML TRIS-SUCROSE Pfizer-BioNTech COVID-19 Vaccine | 6 months - 4 years old | Sept. 11, 2023 |
91319 | SARSCOV2 VACC 10MCG/0.3ML TRIS-SUCROSE Pfizer-BioNTech COVID-19 Vaccine | 5 years - 11 years old | Sept. 11, 2023 |
91320 | SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE Pfizer-BioNTech COVID-19 Vaccine | 12 years and older | Sept. 11, 2023 |
91321 | SARSCOV2 VACCINE 25 MCG/0.25 ML Moderna COVID-19 Vaccine | 6 months - 11 years old | Sept. 11, 2023 |
91322 | SARSCOV2 VACCINE 50 MCG/0.5 ML Moderna COVID-19 Vaccine | 12 years and older | Sept. 11, 2023 |
Vaccines and Toxoids Not Available Through MnVFC
Providers can bill for toxoids, vaccines and vaccine administration not available through MnVFC. Follow Billing for Adult Vaccines protocol under the Immunizations and Vaccinations section in the MHCP Provider Manual for these vaccines.
CPT Code | Description | Ages |
90581 | Anthrax vaccine | 6 weeks - 18 years |
90586 | Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer | 6 weeks - 18 years |
90644 | Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenza type b vaccine (Hib-MenCY), 4 dose schedule | 6 weeks - 3 years |
90649 | Human Papillomavirus vaccine, types 6, 11,16, 18, quadrivalent (4cHPV), 3 dose schedule | 9 - 18 years |
90650 | Human Papillomavirus vaccine, types 16,18, bivalent (2vHPV), 3 dose schedule | 9 - 18 years |
90655 | Influenza virus vaccine, trivalent (IIV3) | 6 weeks - 3 years |
90656 | Influenza virus vaccine, trivalent (IIV3) | 3 - 18 years |
90657 | Influenza virus vaccine, trivalent (IIV3) | 6 weeks - 3 years |
90658 | Influenza virus vaccine, trivalent (IIV3) | 3 - 18 years |
90675 | Rabies vaccine, for intramuscular use | 6 weeks - 18 years |
90676 | Rabies vaccine, for intradermal use | 6 weeks - 18 years |
90685 | Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use | 6 months and older |
90690 | Typhoid vaccine | 6 weeks - 18 years |
90691 | Typhoid vaccine, Vi capsular polysaccharide (ViCPs) | 6 weeks - 18 years |
90717 | Yellow fever vaccine | 6 weeks - 18 years |
90733 | Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4) | 6 weeks - 18 years |
90739 | Hepatitis B vaccine (HepB), 2 dose schedule | 18 years |
90740 | Hepatitis B vaccine (HepB), 2 dose schedule | 2 months - 18 years |
90747 | Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule | 2 months - 18 years |
90748 | Hepatitis B and Haemophilus influenza type b vaccine (Hib-HepB) | 2 months - 18 years |
90749 | Unlisted vaccine/toxoid | 6 weeks - 18 years |
90756 | Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use | 6 months - 18 years |
Q2035 | Influenza - Afluria | 3 - 18 years |
Q2037 | Influenza - Fluvirin | 3 - 18 years |
Q2038 | Influenza - Fluzone | 3 - 18 years |
Q2039 | Influenza virus vaccine, not otherwise specified | 3 - 18 years |
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