Summary & Overview
CPT 90715: Tdap Booster Vaccination for Age 7 and Older
CPT code 90715 designates the Tdap combination booster vaccine used for individuals aged 7 years and older to protect against tetanus, diphtheria, and pertussis. Nationally, Tdap boosters are a key preventive service for reducing morbidity and outbreaks of pertussis and maintaining community immunity for older children, adolescents, and adults. Tracking and proper billing of this vaccine affects immunization delivery, public health reporting, and preventive care quality measures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what CPT code 90715 represents clinically and administratively, typical sites of service, and which payers commonly cover the service. The publication also outlines common billing modifiers and related administrative considerations where available.
The content provides a national perspective for stakeholders interested in vaccination billing, preventive care service lines, and payer coverage patterns. Data not available in the input is noted where relevant, and the focus remains on clinical context, service delivery settings, and the billing code definition that informs coding, claims submission, and routine immunization practice.
Billing Code Overview
CPT code 90715 is a combination tetanus, diphtheria, and acellular pertussis (Tdap) booster vaccine administered to individuals 7 years of age and older to help protect against tetanus (lockjaw), diphtheria, and pertussis (whooping cough). This immunization is used as a booster dose to renew or enhance immunity in patients who have completed a primary vaccination series.
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Service type: Vaccination / preventive immunization booster
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Typical site of service: Outpatient clinic, primary care office, community health center, or other ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A typical patient is a healthy adolescent or adult aged 7 years or older presenting to an outpatient clinic, community health center, school-based immunization program, pharmacy clinic, or primary care office for routine immunization booster protection against tetanus (lockjaw), diphtheria, and pertussis (whooping cough). The clinical workflow includes patient identification and verification of immunization history, informed consent and review of contraindications/allergies, screening for recent illnesses or immunosuppressive conditions, administration of the combination vaccine intramuscularly (typically deltoid), documentation of vaccine lot number, manufacturer, and site, provision of a vaccine information statement to the patient, and scheduling of any recommended follow-up or additional vaccines. Billing and coding staff assign 90715 for administration of the combined tetanus, diphtheria, acellular pertussis (Tdap) booster for patients aged 7 years and older and append applicable modifiers for payer or clinical circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day | When a documented E/M visit is performed for a reason distinct from the vaccine administration and meets E/M documentation requirements |