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New CPT Codes For RSV Vaccine Administration

Centers for Medicare & Medicaid Services added 2 new CPT codes for respiratory syncytial virus (RSV) vaccine administration to the Medicare Physician Fee Schedule. These new codes are effective for date of service on and after October 6, 2023. They are:

Code

Descriptions

WRVUs

Non-facility TRVUs

Administration

Instructional Note

96380

Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified healthcare professional.

0.24

0.68

*Infants < 8 months (during 1st RSV season)

*8 months – 19 months (Children with increased risk of severe RSV disease during 2nd RSV season)

Code also RSV monoclonal antibody, seasonal dose (90380, 90381)

96381

Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection.

0.17

0.59

 

It is currently not recommended that pregnant patients who received the maternal RSV vaccine during the 2023-2024 RSV season, receive an additional dose during a subsequent pregnancy. For patients vaccinated in a previous pregnancy, their infants should receive nirsevimab during the 2024-2025 respiratory season.