Summary & Overview
CPT 90612: Influenza and COVID-19 Combination Vaccine, Intramuscular
CPT code 90612 denotes a combination intramuscular vaccine that delivers both a trivalent influenza component and an mRNA COVID–19 component in a single 0.32 mL dose (31.7 micrograms). Nationally, combination vaccines that streamline delivery of routine seasonal influenza protection with COVID–19 prevention have implications for immunization workflows, supply chain planning, and preventive care rates.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for a one‑dose intramuscular vaccine administered in ambulatory and pharmacy settings, and summarizes what readers will learn: payment and coding benchmarks where available, clinical administration considerations inherent to combination flu/COVID immunizations, and applicable billing guidance. Data not available in the input for specific payer coverage policies, rate benchmarks, associated taxonomies, and ICD‑10 pairings is noted as unavailable.
Readers will gain a concise reference to the code’s clinical meaning, typical sites of service, common modifiers (listed separately in metadata), and where to look for payer‑specific coverage rules. The summary provides a national perspective useful to billing teams, immunization program managers, and policy analysts focused on preventive vaccine delivery and reimbursement logistics.
Billing Code Overview
CPT code 90612 describes a combination intramuscular vaccine that provides protection against seasonal influenza and COVID–19. The product pairs a trivalent influenza vaccine with an mRNA COVID–19 vaccine, delivered as a single intramuscular injection. The total administered dosage is 31.7 micrograms per 0.32 mL.
Service type: Combination preventive immunization (influenza + COVID–19), single intramuscular administration
Typical site of service: Outpatient clinic, primary care office, pharmacy immunization clinic, or other ambulatory vaccination settings
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to a primary care clinic during annual vaccination season seeking protection against both seasonal influenza and COVID-19. The clinician reviews immunization history, screens for contraindications (severe allergic reaction to prior dose or vaccine component, acute moderate or severe illness), documents consent, and administers a single intramuscular injection of the combination vaccine 90612 (trivalent influenza component plus mRNA COVID-19 component; total 31.7 µg per 0.32 mL). The typical workflow includes vaccine verification in the electronic medical record, eligibility and clinical screening, lot number and expiration documentation, administration into the deltoid muscle, post-vaccination observation for 15 minutes for adults with no history of syncope or 30 minutes if there is a history of prior immediate allergic reaction, and recording of the immunization in state immunization information system (IIS) and the patient’s chart. Common sites of service are outpatient primary care office, community health clinic, retail pharmacy-based clinic, or workplace vaccination clinic. The typical patient scenario includes routine seasonal prevention for adults and older adults, especially patients with chronic cardiopulmonary disease, diabetes, immunocompromising conditions, or those at higher exposure risk, who prefer a combined influenza and COVID-19 vaccine in a single intramuscular administration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |