90482-90484 - Who Is Paying For The New Imms Admin?

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    As of January 1, 2026,  we get to enjoy three landmark CPT codes—90482, 90483, and 90484—specifically designed to capture the clinical effort involved in immunization counseling when a vaccine is not administered during the same visit (thank you to those at the AAP who pushed for this). 

    The money isn't huge and I suspect that these codes feel more common than they are, but who cares?  It's a CPT and RVUs that reflect real, cognitive work and time from your practice.  Here's the big question: who is paying?  I'll tell you.

    As of last week, about half of our clients had billed one of these codes this year.  It began slowly, so many of them haven't been adjudicated.  But here's what I can tell you:

    CPT Avg Chg Avg Ins Pmt
    90482 $44.12 $19.16
    90483 $62.23 $29.44
    90484 $75.49 $42.16


    Perhaps just as importantly, here's a list (by state) of the payors who have paid for these codes:

    State Payor   State Payor     State Payor
    AL BCBS   MI Aetna     OK Other
    CA Adventist   MI BCBS     OR Cigna
    CA Aetna   MI Cigna     OR Medicaid
    CA Anthem BC   MI HAP + McLaren     OR Providence
    CA Blue Cross   MI Medicaid     OR UHC
    CA Blue Shield   MI Priority Health     OR UMR
    CA Cigna   MI UHC     PA Aetna
    CA SAG   MO Cigna     PA BC/BS
    CO Cigna   NC Aetna     PA Cigna
    CO CO Medicaid   NC BCBS     PA GHP
    CO RMHP CHP+   NC Cigna     PA Highmark
    CT Aetna   NC UHC     PA UHC Healthcare CHIP
    CT BCBS   NE Cigna     PA UPMC
    CT Cigna   NH Aetna     SC BCBS
    DE Aetna   NH BCBS     TN BCBS
    DE BCBS   NH Cigna     TN BCBS MS
    DE Cigna   NH Harvard Pilgrim     TN Cigna
    DE Medicaid   NH Medicaid     TN Amerigroup
    DE Other   NH METRA HEALTH     TN Bluecare
    FL Aetna   NH NH Healthy Families     TN Other
    FL BCBS   NH UHC     TN UHC
    FL Cigna   NJ Aetna     TN UHC Community TN
    FL Meritain   NJ BCBS     TN Wellpoint TN
    FL UHC HMO   NJ Cigna     TX Aetna
    GA Aetna   NJ Horizon BCBS     TX BCBS
    GA Amerigroup Mcaid CMO   NJ NJ Direct     TX Cigna
    GA BCBS   NJ UHC     TX Community Health Choice
    GA CareSource   NM BCBS     TX IMS/UMC Team Choice
    GA Cigna   NM BLUE Salud     TX Preferred Administrators
    GA Medicaid   NM Php Salud     TX UHC
    GA Peachstate   NV Aetna     VA Aetna
    GA UHC   NY Aetna     VA Anthem
    ID Medicaid   NY Cigna     VA BCBS
    IL BCBS   NY HealthFirst     VA Cigna
    IL Cigna   NY MVP     VA Medicaid
    IL UHC   NY UHC     VI Cigna
    MD Aetna   OH Aetna     VT BCBS
    MD BCBS   OH Anthem Medicaid     VT Cigna
    MD Cigna   OH BCBS     VT UHC Community Plan AHCCCS
    MD MCO   OH CareSource     VT VHP
    MD Medicaid   OH Cigna     WA Aetna
    MD UHC   OH Medicaid OH     WA Cigna
                  WA Medicaid
                  WA Molina
                  WA Premera BCBS
                  WA Regence
                  WA UHC


    A lot the usual suspects are, unusually, paying for these codes.  UHC, CIGNA, even some Medicaid programs.

    What are you waiting for?  Learn more from the AAP here.

     

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