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Last Modified: 12/6/2021 Location: FL, PR, USVI Business: Part A, Part B

Immunizations: Updated coverage of Pneumococcal conjugate vaccine, 20 Valent (PCV20) (CPT 90677)

Recently, Medicare began covering Pneumococcal conjugate vaccine, 20 valent (PCV20) (HCPCS code 90677) effective July 1, 2021. Previously, these codes were denied for dates of service prior to October 1.
Part A MACs will hold claims for these services until the April 2022 system update. Part B MACs will allow claims for PCV20 code 90677 for dates of service on or after July 1, 2021, to process through their systems immediately.
Additionally, First Coast and other MACs will perform mass adjustments for Part B claims previously denied with 90677 for dates of service between July 1 and September 30, 2021. These adjustments will be completed by the end of January 2022.
For more information, please see the claims processing instructions for the new PCV20 code 90677.
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