Summary & Overview
CPT 90694: Quadrivalent Inactivated Adjuvanted Influenza Vaccine, 0.5 mL
CPT code 90694 denotes a 0.5 mL, intramuscular, inactivated, adjuvanted, preservative-free quadrivalent influenza vaccine. This vaccine is part of the seasonal immunization portfolio and supports prevention of four circulating influenza strains, making it integral to national influenza prevention strategies and immunization programs. Widespread coding clarity for this product matters for accurate claims processing, public health reporting, and vaccine uptake tracking.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and billing practices across these payers influence access, site-of-service utilization, and administrative procedures for influenza vaccination.
Readers will find a concise overview of clinical context and service setting, an outline of common payer coverage considerations, and benchmarks and policy-relevant points where available. The publication also highlights typical claims considerations for vaccine administration in outpatient and community settings. Data not available in the input are identified explicitly where applicable.
Billing Code Overview
CPT code 90694 represents an intramuscular, inactivated, adjuvanted, preservative-free influenza vaccine formulated to protect against four influenza strains. The product is supplied as a 0.5 mL dose and is administered intramuscularly.
Service Type: Vaccine administration (influenza, quadrivalent, inactivated, adjuvanted)
Typical Site of Service: Outpatient clinics, physician offices, retail pharmacy clinics, community vaccination sites, and public health clinics
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or older adult presenting for routine seasonal influenza immunization during the annual flu season. The vaccine is an inactivated, adjuvanted, preservative‑free quadrivalent influenza vaccine administered as a 0.5 mL intramuscular injection, most commonly given in a primary care clinic, internal medicine office, family medicine practice, pharmacy clinic, community health center, or public health vaccination clinic. The clinical workflow includes verifying patient identity and eligibility, screening for contraindications (e.g., severe allergy to vaccine components, current moderate or severe illness), obtaining informed consent, documenting the vaccine lot number and expiration, administering the intramuscular injection (deltoid muscle for adults), observing the patient briefly for immediate adverse reactions, and recording the administration in the medical record and immunization registry. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for coverage and billing considerations.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier applicable (placeholder) | Rarely used; indicates standard service without specific modifier when required by payer formatting. |
11 |