Summary & Overview
CPT 90584: Quadrivalent Live Dengue Vaccine, Subcutaneous
CPT code 90584 denotes a quadrivalent live dengue vaccine administered subcutaneously on a two-dose schedule to prevent dengue virus infection. As dengue prevention gains attention in immunization programs, a dedicated vaccine code enables standardized billing, tracking of vaccine uptake, and clearer communication among providers, payers, and public health entities. The code applies to outpatient immunization services typically delivered in clinics, primary care offices, public health clinics, or specialized immunization centers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of the clinical context for dengue vaccination, what CPT code 90584 represents for billing workflows, and the practical implications for outpatient vaccine delivery. The publication summarizes available benchmarks where present, highlights policy and coverage considerations relevant to major payers, and outlines common billing elements associated with vaccine administration. Data not available in the input is noted where applicable. This piece is intended to inform billing staff, immunization program managers, and policy analysts about the coding and service context for the dengue vaccine represented by CPT code 90584.
Billing Code Overview
CPT code 90584 represents a quadrivalent live dengue vaccine administered subcutaneously. The product is supplied as a two-dose schedule intended to provide immunization against dengue virus, the cause of dengue fever.
Service Type: Vaccine administration / Immunization service
Typical Site of Service: Outpatient clinic, primary care office, public health clinic, or immunization center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 28-year-old traveler planning a multi-week visit to a dengue-endemic region presents to a primary care clinic for pre-travel immunization. The clinician documents travel itinerary, screens for contraindications (pregnancy, severe immunodeficiency, prior dengue vaccination), reviews vaccine risks and benefits, and obtains informed consent. The quadrivalent live dengue vaccine is administered subcutaneously as the first of a two-dose series, with scheduling for the second dose per product guidance. Typical workflow includes patient intake, medical history and allergy review, medication reconciliation, vaccine eligibility screening, administration in an outpatient clinic or travel medicine clinic, post-vaccination observation for adverse reactions (usually 15–30 minutes), documentation in the medical record and immunization registry, and billing using the vaccine administration code 90584. Typical site of service is outpatient physician office or travel medicine clinic; community health centers and public health clinics also commonly provide this vaccine. Patient education materials and follow-up appointment scheduling are provided prior to discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when documentation supports substantially greater effort, time, or complexity for vaccine administration (e.g., extensive counseling or management of complex comorbidities) and payer allows modifier for vaccine services. |