90696 Dtap-ipv vaccine 4-6 yrs im

What 90696 is

CMS fee schedule short descriptor: Dtap-ipv vaccine 4-6 yrs im.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 90696 (CY2026)

This code has no Physician Fee Schedule rate: Excluded from the Physician Fee Schedule (paid under another system or not priced here). It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

Medically Unlikely Edit (MUE)

Medicare caps 90696 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 90696? These codes are bundled into it

90696 is a Column 1 code in 10 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

90696 is bundled into these codes

90696 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 90696 is the code that denies.

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.