As of January 1, 2026, practices can now bill for immunization counseling provided on a date when no vaccine is administered. These new CPT codes acknowledge the growing amount of time pediatric clinicians spend addressing vaccine questions, educating families, and supporting informed decision-making even when a vaccine isn’t given that day.
New Time‑Based Immunization Counseling Codes
These codes are time-based and must be supported by documentation reflecting the total counseling time separate from any other services provided:
- 90482 – Immunization counseling by a physician or other qualified health care professional when immunization(s) is not administered on the same date of service; 3 minutes up to 10 minutes
wRVU = .24 - 90483 – Greater than 10 minutes up to 20 minutes
wRVU = .50 - 90484 – Greater than 20 minutes
wRVU = .75
Billing Considerations
When these counseling codes are reported in addition to an E/M visit, practices must append modifier 25 to the E/M code. This indicates that the evaluation and management service is separately identifiable and distinct from the immunization counseling.
What Practices Should Do Now
Before incorporating these codes into your workflow, practice leaders should:
- Verify payment rates and coverage details with major payers.
- Update charge capture, billing workflows, and staff training materials.
- Ensure documentation templates accurately reflect time spent on immunization counseling.
- Use CPP as a resource for payer updates and billing guidance. CPP maintains a centralized library of payer updates, billing considerations, and reimbursement tools.
Proactively confirming payer policies will help avoid claim denials and ensure practices are properly reimbursed for the counseling services they’re already providing.
