$20.24
90471 reports the first intramuscular or subcutaneous vaccine in the encounter; 90472 reports each additional vaccine and requires a primary procedure.
On this page
CMS RVU26D · Effective 2026-10-01
90472 Vaccine administration Medicare reimbursement rates in Kentucky
Reports administration of each additional intramuscular or subcutaneous vaccine after the first vaccine in an encounter, when the add-on requirements are met. Compare 90472 office and facility rates across CMS payment localities in Kentucky.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90472 in Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$14.82
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Immunization administration
About 90472: Additional intramuscular or subcutaneous vaccine administration
Reports administration of each additional intramuscular or subcutaneous vaccine after the first vaccine in an encounter, when the add-on requirements are met.
90472 represents administration of each additional vaccine after the first intramuscular or subcutaneous vaccine during an encounter. It covers the administration work, not the vaccine product; report the product separately when applicable. Nurses and other clinical staff commonly perform the service in an office or clinic. For pediatric visits, the standard administration codes may be appropriate when the face-to-face physician or qualified health professional counseling circumstance for 90460 and 90461 is not present.
Report 90471 for the first vaccine and 90472 for each additional vaccine administered by the intramuscular or subcutaneous route. Do not count the components of a combination vaccine as separate administrations. Documentation should identify the vaccine products, routes, and which administration was first versus additional. As an add-on, 90472 must be reported with a primary procedure and CMS payment is within that procedure’s global period. Under the CMS incident-to rule, report it only when performed under physician supervision.
CMS billing rules for 90472
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.15 · 31%
- Practice expense (office) RVU0.32 · 67%
- Malpractice RVU0.01 · 2%
23.8K
Medicare services in 2024 · #1067 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
90472 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$11.55
90474 is for each additional vaccine given orally or intranasally. Use 90472 for additional intramuscular or subcutaneous vaccine administrations.
$8.40
90461 reports additional vaccine components in the qualifying pediatric counseling-based administration sequence. 90472 counts additional vaccines in the standard intramuscular or subcutaneous sequence.
Compare 90472 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Kentucky →
Office / nonfacility
$14.82
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 90472 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
11,415
- Code
- 90472
- Physician work
- 0.15
- Practice expense
- 0.32
- Malpractice
- 0.01
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.15 | × 1.000 | 0.1500 |
| Practice expense | 0.32 | × 0.889 | 0.2845 |
| Malpractice | 0.01 | × 0.915 | 0.0092 |
| Total RVUs | 0.4436 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$14.82
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.15 | 1 |
| Practice expense | 0.32 | 0.889 |
| Malpractice | 0.01 | 0.915 |
(0.15 × 1 + 0.32 × 0.889 + 0.01 × 0.915) × $33.4009 = $14.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
90472 billing questions
Which code reports the first intramuscular or subcutaneous vaccine?
Use 90471 for the first vaccine and 90472 for each additional vaccine administered by either route.
Can 90472 be reported without 90471?
No. It is an add-on code and must be reported with a qualifying primary procedure; for this administration sequence, report 90471 for the first vaccine.
Is the vaccine product included in 90472?
No. 90472 represents administration. Report the vaccine product separately when applicable.
How should a combination vaccine be counted?
Count the combination vaccine as one administered vaccine, not as separate administrations for each component.
What documentation supports reporting 90472?
Document the vaccine administered, its route, and that it was an additional vaccine after the first. CMS requires physician supervision for incident-to billing.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,41290460,,Im admin 1st/only component,A,,0.23,0.45,,0.45,NA,0.02,0.70,0.70,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,41390461,,Im admin each addl component,A,,0.18,0.07,,0.07,NA,0.01,0.26,0.26,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,41490471,,Immunization admin,A,,0.17,0.48,,0.48,NA,0.01,0.66,0.66,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,41590472,,Immunization admin each add,A,,0.15,0.32,,0.32,NA,0.01,0.48,0.48,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,41690473,,Immune admin oral/nasal,A,,0.17,0.34,,0.34,NA,0.01,0.52,0.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,41790474,,Immune admin oral/nasal addl,A,,0.15,0.21,,0.21,NA,0.01,0.37,0.37,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,41890476,,Adenovirus vaccine type 4,E,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631