Human Papilloma Virus (HPV) Vaccine for Males
Author: peach stateThis entry was posted on 12 July 2010 and is filed under Blog, News.
Dear Peach State Provider:
The Advisory Committee on Immunization Practices (ACIP) now recommends the use of the quadrivalent HPV vaccine, Gardasil, for males, ages 9 to 21 years. Based on the ACIP recommendation and effective immediately, Peach State Health Plan will accept CPT code 90649 for females AND males, ages 9 to 21 years enrolled in the Georgia Medicaid and Peach Care for Kids programs.
The HPV vaccine will be supplied through the Vaccines for Children Program for males, ages 9 to 18 years, 11 months. The vaccine reimbursement is $8.00 for ages 9 to 18 years, 11 months. Males, ages 19 to 21 will be reimbursed according to the rate contained in your Peach State contract.
Providers should submit claims using the following billing guidelines:
| CPT Code | Diagnosis Code | Modifier | Age Range |
| 90649 | V04.89 or V05.0038 | EP | 9 years – 18 years,11 mo |
| 90649 | 19 years – 21 years |
If you have any questions about this communication, please contact Peach State Provider Services at 1-866-874-0633. We will be happy to assist you.
Thank you.
Peach State Health Plan
