CPT 90620: Meningococcal Group B Vaccine, Recombinant + OMV - OpenPayer

Summary & Overview

CPT 90620: Meningococcal Group B Vaccine, Recombinant + OMV

CPT code 90620 denotes a recombinant protein and outer membrane vesicle (OMV) meningococcal serogroup B vaccine given intramuscularly. This vaccine is an important preventive intervention against serogroup B meningococcal disease, which can cause meningitis and septicemia. Nationally, vaccination policy and coverage decisions influence uptake, access, and public health impact.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and service type associated with the code. The publication summarizes benchmarking points used by major payers, common billing considerations, and relevant policy or coding updates where available.

The content is intended to inform revenue cycle and clinical administrative teams about how CPT code 90620 is classified, where it is typically administered, and which national payers commonly cover this service. Data not available in the input is indicated where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare90620CPTmeningococcal B vaccinevaccine administrationimmunizationrecombinant proteinsouter membrane vesiclesambulatory carepreventive care

Billing Code Overview

CPT code 90620 describes a meningococcal group B vaccine administered intramuscularly to protect against meningococcal disease caused by serogroup B. The vaccine formulation uses recombinant proteins and outer membrane vesicles to stimulate an immune response.

Service Type: Vaccine administration (intramuscular)

Typical Site of Service: Outpatient clinic, physician office, public health clinic, or other ambulatory care settings where intramuscular vaccines are given

Clinical & Coding Specifications

Clinical Context

A 17-year-old adolescent presents to a primary care clinic for routine immunization prior to college residence. The patient has no current febrile illness and reports no known severe allergies to vaccine components. After informed consent, the clinician administers an intramuscular dose of a meningococcal serogroup B vaccine (90620) using standard aseptic technique in the deltoid. The visit includes review of vaccination history, screening for contraindications (severe allergic reaction to prior dose or vaccine component), documentation of lot number and site, and counseling on expected local and systemic reactions. The procedure is commonly billed as a single administration vaccine encounter; billing may occur with an office visit code when significant, separately identifiable evaluation and management services are provided on the same day and appropriately documented.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service on the same day	Use when a distinct E/M visit is performed and documented in addition to vaccine administration.
`33`	Preventive service

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CPT 90707: MMR Vaccine, Subcutaneous Immunization

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CPT 90732: Pneumococcal Polysaccharide Vaccine Administration, Age 2+

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CPT 90680: Live Pentavalent Rotavirus Vaccine, Oral Three-Dose

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CPT 90714: Diphtheria and Tetanus Preservative‑Free Vaccine IM

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CPT 90675: Rabies Vaccine, Intramuscular

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Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary vaccinators in outpatient clinics and college health centers.
`207R00000X`	Internal Medicine	Provide adult/adolescent immunizations in primary care settings.
`208000000X`	Pediatrics	Common providers for adolescent and pediatric vaccine administration.
`335600000X`	Public Health Nurse	Administer vaccines in community clinics, school-based programs, and public health settings.
`363L00000X`	Registered Nurse	Frequently administers routine intramuscular vaccines under provider delegation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z23`	Encounter for immunization	Primary diagnosis code used to indicate the patient encounter is for routine vaccination, including `90620` administration.
`Z28.1`	Underimmunization status	Used when documenting that the patient is not up to date on meningococcal vaccination and receives `90620` to complete schedule.
`Z71.89`	Other specified counseling	Used when vaccine counseling (risk/benefit, side effects) is a significant part of the encounter.
`T88.1XXA`	Other complications following immunization, initial encounter	Used if the patient experiences a documented adverse reaction to the vaccine at the encounter.
`R50.9`	Fever, unspecified	May be used if the patient presents with fever related to an adverse event following immunization and requires evaluation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90471`	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular), one vaccine (single or combination vaccine/toxoid)	Used to report the administration service when separate from vaccine product billing; often billed with vaccine J-code or when payer requires administration code.
`90472`	Immunization administration, each additional vaccine (single or combination vaccine/toxoid)	Used when multiple vaccines are administered in the same visit in addition to the first administration code.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M code when a separately identifiable evaluation and management service is provided on the same day as vaccination and modifier `25` is appended.
`99070`	Supplies and materials provided by the physician over and above those usually included with the office visit	Used to report vaccine administration supplies if payer permits separate supply charges.
`90460`	Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component	Alternate administration code used in some payer policies when counseling is specifically documented for patients under 18.

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