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CPT 90460: Single Live Attenuated Vaccine Administration, Pediatric
CPT code 90460 designates the administration of a single live attenuated vaccine to patients through age 18 using any route (parenteral, oral, intranasal, intramuscular, or intravenous). This code captures the clinical act of delivering one live attenuated vaccine dose in pediatric settings and is widely used across outpatient and ambulatory care sites where immunizations are provided. Its clear definition supports consistent billing for routine childhood and adolescent immunization services and affects national vaccination program workflows and payer coverage policies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common service locations, and how this code relates to adjacent immunization administration codes used for additional vaccines or when counseling is provided. The publication also outlines typical payer considerations and common modifiers used with immunization services (modifier list provided separately) and identifies associated provider taxonomies commonly billing this service.
This resource is intended to help billing managers, clinicians, and policy staff understand where CPT code 90460 fits within immunization coding practice, how it relates to related administration codes, and what operational contexts commonly apply. Data not available in the input is noted where relevant.
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Billing Code Overview
CPT code 90460 describes the administration of a single live attenuated vaccine to a patient up to 18 years of age. The vaccine may be given by parenteral, oral, intranasal, intramuscular, or intravenous routes. This procedure represents the clinical act of delivering one live attenuated vaccine dose to a pediatric patient.
Service type: Vaccine administration (single live attenuated vaccine) for patients up to 18 years of age
Typical site of service: Outpatient clinic, pediatric or family medicine office, school-based clinic, community health clinic, or other ambulatory care settings where immunizations are provided
National Reimbursement Benchmarks
Medicare’s mean rate of $24.2 sits below BUCA’s average commercial mean of $34.4, indicating Medicare pays roughly $10.2 less on average for CPT 90460 than this commercial benchmark. That gap highlights a modest but meaningful difference between federal program reimbursement and a mid-sized commercial payer aggregate, with BUCA more aligned with other commercial means such as Aetna and Cigna.
Dispersion measured as P75 minus P25 is widest for Aetna at $66.8 (P75 $91.9 minus P25 $23.2) and narrowest for Blue Cross Blue Shield at $10.8 (P75 $32.6 minus P25 $21.8). UnitedHealth Group and Cigna show intermediate spreads of $18.2 and $13.7 respectively, while BUCA’s interquartile spread is $20.0 and Medicare’s IQR is $2.0, indicating Medicare rates are the tightest around the median.