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24.3.20.2 Vaccines/Toxoids
The vaccines/toxoids listed in the following table are a benefit of the CSHCN Services Program:
The procedure code for the vaccine/toxoid and the appropriate administration code must be submitted on the claim. Claims may be reimbursed according to the administration code submitted.
The vaccine/toxoid procedure codes in the preceding table identify only the vaccine product. Use an immunization administration code to report the administration of a vaccine or toxoid.
Procedure codes 1-90669 and 1-90732 are payable once per lifetime, except with documentation of medical necessity for additional doses.
To receive the pneumococcal polysaccharide vaccine more than once in a lifetime, the client must be over two years of age and have a long-term health problem that would lower the body's resistance to infection.
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