Wiki Pediatric Vaccines with Flu


Kenai, AK
Best answers
Hi All,

When billing pediatric vaccines, I am aware that you have to bill by component. Our clinic offers a flu shot at a discounted price for every flu season. The flu discount is cheaper than our regular administration charges.
For example, let's say that our flu shot is $30 (we charge through administration fee and bill the vaccine itself as $0). Our initial administration charge is $60 and additional immunization charge is $37 ea. If I have a child who came in for flu, Hep A, and HIB - how do we capture the $30 flu discount, but also capture the first components of the other vaccines? Are there any better suggestions on how we need to be billing these?

90460 for flu is $30
90460 for other vaccines is $60
90461 for addtl' vaccines is $37 ea
Is there a reason that you would not charge for the Flu shot itself if the patient has insurance? Also what code are you using for HIB? We give our HIB in a combination vaccine. If there is NOT more than one component in the HIB vaccine, then you would charge for all 3 of those vaccines & 90460x3; 90461 would only be used for additional components.

Hope that helps
Kim Krebs