CPT 90746: Hepatitis B Vaccine, Adult Dosage, Intramuscular

CPT code 90746 denotes an adult‐dosage hepatitis B vaccine administered intramuscularly as part of a three‑dose immunization series. This preventive service is significant nationally because hepatitis B vaccination reduces the incidence of a contagious liver disease with substantial public health and healthcare utilization implications. The code is commonly used in outpatient immunization settings, including physician offices, community clinics, pharmacies, and public health programs.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of CPT code 90746, typical sites of service, and the procedural nature of a three‑dose adult hepatitis B vaccine. The publication also outlines payer coverage considerations, common billing modifiers associated with vaccine administration, and related service‑line implications.

This summary equips billing professionals, clinic administrators, and policy analysts with practical knowledge about the code’s clinical role, the settings where it is billed, and where to focus when reviewing reimbursement policies or coding practices. Data not available in the input is noted where applicable.

Billing Code Overview

CPT code 90746 represents an adult–dosage hepatitis B vaccine administered intramuscularly. The vaccine is intended to protect against hepatitis B, a liver infection caused by the hepatitis B virus, and follows a three–dose schedule.

Service Type: Vaccine administration (preventive immunization)

Typical Site of Service: Outpatient clinics, physician offices, public health clinics, and pharmacies offering immunizations

Data not available in the input.

Clinical Context

An adult patient presents to a primary care clinic for routine immunization to complete a three‑dose hepatitis B vaccination series. The patient is an adult (age ≥19) with no contraindications to intramuscular vaccines, requests protection against hepatitis B due to occupational exposure risk (e.g., healthcare worker) or known risk behaviors, and is scheduled for dose 1, dose 2, or dose 3 of the adult hepatitis B vaccine. The clinical workflow includes verification of immunization history and informed consent, screening for contraindications (severe allergic reaction to a prior dose or vaccine component), preparation of the appropriate adult‑dosage hepatitis B vaccine, intramuscular administration (typically in the deltoid), documentation of lot number and manufacturer, and provision of aftercare instructions. Billing is submitted using 90746 for the adult‑dosage hepatitis B vaccine, with relevant visit evaluation and management codes billed separately when applicable. Typical sites of service are outpatient primary care clinics, occupational health clinics, urgent care centers, public health clinics, and hospital outpatient departments.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the same day	Use when a distinct E/M visit is provided in addition to vaccine administration during the same encounter

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Common provider specialty administering adult vaccines in outpatient settings
`207R00000X`	Internal Medicine	Primary care internists frequently administer adult hepatitis B vaccine
`207L00000X`	Emergency Medicine	Urgent care and emergency departments may provide catch‑up vaccinations
`3336C0003X`	Occupational Medicine	Occupational health clinics administer vaccines for workplace exposure risk
`363LP0800X`	Public Health	Public health nurses and clinics deliver vaccine programs

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z23`	Encounter for immunization	Most commonly used diagnosis code to indicate administration of a vaccine, including hepatitis B
`Z72.0`	Tobacco use	Indicates behavioral risk factor that may be reviewed during vaccine counseling; not a direct indication but often documented in adult preventive care
`Z77.21`	Contact with and (suspected) exposure to potentially communicable disease — hepatitis B	Used when patient reports known exposure risk warranting vaccination or post‑exposure evaluation
`Z20.9`	Contact with and (suspected) exposure to unspecified communicable disease	Broad code used when documenting exposure concerns prompting vaccination
`Z29.1`	Prophylactic vaccination and inoculation against single disease	Used when documenting preventive vaccine administration for a specific disease such as hepatitis B

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90471`	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular) - first vaccine/toxoid component	Used to report the administration of a single vaccine when billing for administration separate from vaccine product cost
`90472`	Immunization administration - each additional vaccine/toxoid component (list separately in addition to code for primary procedure)	Used when multiple vaccines are given at the same encounter in addition to the hepatitis B vaccine
`90746`	Hepatitis B vaccine, adult dosage, intramuscular, 3 dose schedule	Primary vaccine product code for adult hepatitis B vaccine (the service described)
`99401`	Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (15 minutes)	May be billed separately for counseling related to hepatitis B risks and vaccine counseling when time‑based counseling meets payer criteria
`G0008`	Administration of influenza vaccine (Medicare-specific)	Example of other vaccine administration codes used in adult vaccination workflows; not billed with `90746` for hepatitis B but commonly performed in the same clinic visit

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Summary & Overview