By Jimmie Hebert, CPC, CMCA-EM, CMC, CMOM, CMIS
Patients sometimes decline vaccinations for many reasons. Some are concerned about the safety of a new vaccine or have doubts about its efficacy. Others may not be concerned about the ingredients and the danger of possible side effects, while others believe their risk of contracting the disease if very low. Often providers spend time counseling the patients on vaccines. Effective January 1, 2026, the American Medical Association created three new immunization counseling codes to be used when such counseling is provided AND no vaccine was administered on the same date. These codes are time based and time must be documented.
- 90482: Immunization counseling; 3 minutes up to 10 minutes.
- 90483: Immunization counseling; greater than 10 minutes up to 20 minutes.
- 90484: Immunization counseling; greater than 20 minutes.
When to report the immunization counseling codes:
- counseling is performed by the physician or APP BUT the immunization is not performed on this date. to report the immunization counseling codes:
How
- report once per date of service for cumulative counseling time for immunization(s) not provided, regardless of the number of products.
Documentation Requirements:
These codes are time based.
- Time and a summary of the counseling shall be documented.
Note: Verification of benefits is important. Some plans do not recognize these codes as a covered benefit. Texas Medicaid Health Plan and Texas Medicaid Managed Care plans have not added these codes to their list of covered services and therefore do not recognize these codes for reimbursement.