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Pneumococcal 20-Valent Conjugate Vaccine Age Range Expansion

Date: 01/31/24

Effective for dates of service on or after September 1, 2023, the age range for procedure code 90677 (Pneumococcal 20-Valent Conjugate Vaccine) was updated for Medicaid and CHIP individuals who are 2 months of age or older. Since this vaccine is distributed by the Texas Vaccines for Children (TVFC) Program, procedure code 90677 will process as informational-only when administered to individuals who are 2 months through 18 years of age.

Superior HealthPlan will reprocess affected claims submitted with this procedure code and date of service on or after September 1, 2023.

Please note, providers are:

  • Not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.
  • Encouraged to bill Superior retroactively for vaccine procedure code 90677 and related vaccine administration procedure code.

For any questions, please contact your Account Manager. To access their contact information visit Find My Account Manager.