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    v1.0.28
    OpenPayerBilling CodesVaccines, ToxoidsCPT cpt-90613-flu-covid19-combination-vaccine-im-injection
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    CPT 90613: Quadrivalent Influenza + mRNA COVID-19 Combination Vaccine IM

    CPT code 90613 describes a single intramuscular combination vaccine dose that contains a quadrivalent influenza vaccine plus an mRNA COVID‑19 vaccine (total 40 micrograms per 0.4 mL) administered to provide simultaneous protection against influenza and COVID‑19; service type is combination immunization and the typical site of service is outpatient clinics, physician offices, and vaccination centers where intramuscular vaccines are given.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old adult presents to a primary care clinic during fall vaccination season for routine immunizations. The patient has a history of chronic obstructive pulmonary disease (COPD) and hypertension and requests contemporaneous protection against seasonal influenza and COVID-19. The clinician verifies immunization history, reviews contraindications (e.g., severe prior allergic reaction to vaccine components), obtains informed consent, and documents the indication. The combined intramuscular vaccine product 90613 (quadrivalent influenza plus mRNA COVID-19, 40 mcg/0.4 mL) is prepared and administered into the deltoid muscle using aseptic technique. The patient is observed in the clinic for 15 minutes for immediate adverse reactions. Documentation includes vaccine lot number, manufacturer, expiration date, administration site and route, dosage, patient consent, and any post‑administration counseling. Billing is submitted to the patient’s payer with 90613 and any applicable modifier for unusual circumstances (e.g., increased procedural services), following payer-specific coverage rules.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    90471Immunization administration (single vaccine), intramuscular, any ageUsed to report vaccine administration when payer requires separate administration code for a single vaccine administration; may be billed with 90613 depending on payer rules.
    90472Immunization administration (each additional vaccine)Not typically applicable when 90613 is a single combined product; used when multiple separate vaccines are administered in same encounter.
    99213Office or other outpatient visit, established patient, low to moderate complexityRepresents the evaluation and management service when a separate visit is performed the same day as vaccine administration and billing criteria are met.
    90460Immunization administration via any route; first vaccine/toxoid component (when counseling provided)Alternative vaccine administration codes used when counseling and vaccine counseling/time-based components are documented and required by payer; usage varies by payer.
    90461Immunization administration via any route; each additional vaccine/toxoid componentUsed for additional components when multiple distinct vaccines are administered and single-product bundling does not apply.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    47Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    390200000XStudent in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensur…
    163WE0900XEnterostomal Therapy Registered NurseNursing Service Providers · Registered Nurse
    103K00000XBehavior AnalystA behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …
    2278E1000XEducational Certified Respiratory TherapistThe focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapis…
    207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianA family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesse…

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    9 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01

    Related Codes

    CPT-90476-ADENOVIRUS-TYPE-4-ORAL-VACCINE-ADMINISTRATION

    CPT 90476: Oral Live Vaccine for Adenovirus Type 4

    CPT-90477-ORAL-LIVE-ADENOVIRUS-TYPE-7-VACCINE

    CPT 90477: Oral Live Adenovirus Type 7 Vaccine Administration

    CPT-90581-ANTHRAX-VACCINE-INJECTION

    CPT 90581: Anthrax Vaccine, Injection

    CPT-90584-QUADRIVALENT-LIVE-DENGUE-VACCINE-SUBCUTANEOUS

    CPT 90584: Quadrivalent Live Dengue Vaccine, Subcutaneous, Two-Dose

    CPT-90585-TB-LIVE-INTRADERMAL-VACCINE

    CPT 90585: Live Tuberculosis Vaccine Administered Through the Skin

    CPT-90586-INTRAVESICAL-LIVE-VACCINE-BLADDER-CANCER

    CPT 90586: Intravesical Live Vaccine for Bladder Cancer

    CPT-90587-DENGUE-VACCINE-SUBCUTANEOUS-THREE-DOSE

    CPT 90587: Quadrivalent Live Dengue Vaccine, Subcutaneous, Three-Dose

    CPT-90589-CHIKUNGUNYA-VACCINE-INTRAMUSCULAR-LIVE-ATTENUATED

    CPT 90589: Chikungunya Vaccine, Live Attenuated, Intramuscular

    CPT-90593-RECOMBINANT-CHIKUNGUNYA-VACCINE-INTRAMUSCULAR

    CPT 90593: Recombinant Chikungunya Vaccine, Intramuscular

    CPT-90611-SMALLPOX-MONKEYPOX-VACCINE-SUBCUTANEOUS-05ML

    CPT 90611: Combined Smallpox and Monkeypox Vaccine, Subcutaneous 0.5 mL

    Showing 1–10 of 101

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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