CPT 2026 · Vaccines/Immunization

CPT 90613

Global XXX

Inf&sarscov2 vacc 40/0.4 im

Effective 2026-04-01 Conv. factor $33.4009
No national RVU
Payment Methodology
X
Status Indicator
0
NCCI Partners
XXX
Global Period
No national RVU

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

CPT 90613 Billing & Documentation Guide

CPT code 90613 (Inf&sarscov2 vacc 40/0.4 im) is classified under Vaccines/Immunization with a global period indicator of XXX. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 90613, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify current NCCI edits before bundling with related codes.

Payment Status & Global Period

CMS Status Indicator
X

Statutory exclusion

Global Period
XXX

No global period (E/M and other non-procedural services)

Frequently Asked Questions, CPT 90613

What does CPT code 90613 mean? +

CPT code 90613 represents: Inf&sarscov2 vacc 40/0.4 im. It's in the Vaccines/Immunization category with a global period of XXX.

What is the Medicare reimbursement for CPT 90613? +

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

What modifiers can I use with CPT 90613? +

Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.

What bundling edits apply to CPT 90613? +

No NCCI PTP edits currently on file for this code.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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