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90653

Influenza vaccine, inactivated (IIV), subunit, adjuvanted, 0.5 mL dosage, for intramuscular use

Medicine Immunizations 0.00 Total RVUs
Quick Reference
Influenza vaccine, inactivated, subunit, adjuvanted

Relative Value Units (RVUs)

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Work RVU
0.00
Physician effort
PE RVU
0.00
Practice expense
MP RVU
0.00
Malpractice
Total RVU
0.00
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

Influenza vaccine, inactivated, subunit, adjuvanted

Time Requirement
Vaccine product code

Common Scenarios

Adjuvanted flu vaccine
IIV subunit vaccine
Enhanced flu vaccine

Documentation Requirements

  • Vaccine product documented
  • Patient response

Coding Guidelines

Common Modifiers

59 Distinct procedural service

Bundling Rules

  • Vaccine product code
  • Bill separately from administration

Exclusions

  • Do not bill with administration included

Coding Notes

Vaccine product code
Adjuvanted

Clinical scenarios

Adjuvanted flu vaccine
Adjuvanted flu vaccine
When to use:Influenza vaccine, inactivated, subunit, adjuvanted
  • Vaccine product documented
  • Patient response
IIV subunit vaccine
IIV subunit vaccine
When to use:Influenza vaccine, inactivated, subunit, adjuvanted
  • Vaccine product documented
  • Patient response
Enhanced flu vaccine
Enhanced flu vaccine
When to use:Influenza vaccine, inactivated, subunit, adjuvanted
  • Vaccine product documented
  • Patient response

Who are you?

Code Details

Code 90653
Category Medicine
Subcategory Immunizations
Total RVUs 0.00

Medicare Pricing

PFS
2025 National Rate
$0.00
Facility
$0.00
Non-Facility
$0.00
RVU Breakdown
Work RVU:0.00PE RVU:0.00MP RVU:0.00Total RVU:0.00CF:$32.3465Global Days:XXX
OPPS Details
Status:LCopayment:$0.00

Dosage: 0.5 ML

Payment Limit: $98.16

Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 90653?

CPT 90653 is the billing code for "Influenza vaccine, inactivated (IIV), subunit, adjuvanted, 0.5 mL dosage, for intramuscular use". Influenza vaccine, inactivated, subunit, adjuvanted

What documentation is required for CPT 90653?

Key documentation requirements for CPT 90653 include: Vaccine product documented; Patient response. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 90653 be billed with other codes?

Bundling considerations for CPT 90653: Vaccine product code. Bill separately from administration Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 90653?

Common modifiers for CPT 90653 include: 59 (Distinct procedural service). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 90653?

The typical time requirement for CPT 90653 is Vaccine product code. Time-based codes require documentation of the actual time spent providing the service.

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