This SPA looks to amend Attachment 4.19-B of the Medicaid State Plan to add the following Current Procedure Terminology codes to the Medical Clinic and Physician Office and Outpatient fee schedules: 90620 (Meningococcal recombinant protein and outer membrane vesicle vaccine, Serogroup B, 2 dose schedule, for intramuscular) and 90621 (Meningococcal recombinant lipoprotein vaccine, Serogroup B, 3 dose schedule, for intramuscular use). This change is being made because for 2015, these two codes have been approved as vaccinations against the influenza virus by the U.S Food and Drug Administration (FDA).
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File 1 - Approval Document Media