CPT 90634: Hepatitis A Vaccine, Pediatric/Adolescent, IM, Three-Dose

CPT code 90634 identifies the pediatric/adolescent formulation of the hepatitis A vaccine administered intramuscularly on a three–dose schedule to protect against hepatitis A infection. This vaccine code is nationally relevant due to routine childhood and adolescent immunization schedules, public health prevention priorities, and its inclusion in payer vaccine coverage policies. Vaccination coding affects billing for preventive care services, immunization reporting, and public health tracking.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for use of the code, typical sites of service where the vaccine is administered, and the role this code plays in vaccine delivery workflows. The publication also provides benchmarking and policy-oriented content where available, including common payer coverage practices and billing considerations relevant to immunization services.

This summary is national in scope and intended to inform billing staff, practice managers, and health policy professionals about the clinical purpose of CPT code 90634, the service contexts in which it applies, and the types of payer policies and benchmarks that commonly affect vaccine reimbursement and reporting. Data not available in the input will be identified where applicable.

Billing Code Overview

CPT code 90634 represents a pediatric/adolescent hepatitis A vaccine formulated for intramuscular administration. The code is specific to the pediatric/adolescent dosage and denotes a three–dose vaccination schedule intended to protect against hepatitis A, an infectious liver disease.

Service Type: Vaccine administration (pediatric/adolescent hepatitis A immunization)

Typical Site of Service: Outpatient clinics, pediatric offices, public health clinics, and other ambulatory care settings where routine vaccinations are provided

Clinical Context

A 12-month-old child presents to a pediatric primary care clinic for routine immunizations. The child is due to start the pediatric/adolescent hepatitis A vaccine series administered intramuscularly on a three–dose schedule. A nurse verifies immunization history and contraindications, obtains parental consent, reviews vaccine lot number and expiration, prepares the 90634 vaccine, and administers it intramuscularly (typically in the anterolateral thigh for infants and deltoid for older children). The visit includes documentation of vaccine administration (date, vaccine name, CVX code, lot number, manufacturer, dose, site, route), screening for acute illness or allergy, and scheduling follow-up doses per the three–dose series. Billing is submitted under CPT 90634 with the appropriate patient and encounter identifiers and any applicable modifier(s) to indicate special circumstances (for example, anatomic site or service interruptions). Typical site of service is a pediatric or family medicine outpatient clinic, community health center, or public health immunization clinic. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for eligible beneficiaries.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier required / default	Use when no special circumstances apply to the vaccine administration

Taxonomy Code	Specialty	Notes
`208000000X`	Pediatrics	Primary specialty delivering pediatric vaccines
`208000000P`	Family Medicine	Common outpatient providers administering childhood vaccines
`363L00000X`	Public Health	Clinics and health departments providing immunizations
`363A00000X`	Ambulatory Care	Community health centers and outpatient clinics
`206Q00000X`	Nurse Practitioner	NPs commonly administer and document vaccines

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z23`	Encounter for immunization	Primary diagnosis code used to report routine administration of vaccines including `90634`
`Z20.9`	Contact with and (suspected) exposure to communicable disease, unspecified	Used when vaccination is provided due to potential exposure risk
`Z71.89`	Other specified counseling related to health or medical issues	Used when vaccine counseling or education is a documented component of the visit
`Z00.129`	Encounter for routine child health examination without abnormal findings	Used when vaccine administered during a well-child visit
`R50.9`	Fever, unspecified	May be used if vaccine visit addresses post-immunization fever or if vaccinating during mild febrile illness per clinical judgment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90460`	Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered	Used when vaccine counseling is provided and billed separately in addition to vaccine product
`90461`	Each additional vaccine/toxoid component administered (List separately in addition to code for primary vaccine administration)	Used when multiple vaccines are administered at the same visit alongside `90634`
`90471`	Immunization administration (single or first component) 0 through 18 years via intramuscular or subcutaneous injection	Alternate administration code for single vaccine when counseling is not separately reported
`90472`	Each additional vaccine administered (intramuscular/subcutaneous)	Additional administration code when more than one injectable vaccine is given
`90632`	Hepatitis A vaccine, pediatric/adolescent dosage, 2-dose schedule, for intramuscular use	Related hepatitis A product for different dosing schedule; relevant when selecting appropriate product code based on dosing schedule

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Summary & Overview