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90700 Dtap vaccine < 7 yrs im

What 90700 is

CMS fee schedule short descriptor: Dtap vaccine < 7 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 90700 (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.

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Medically Unlikely Edit (MUE)

Medicare caps 90700 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 90700? These codes are bundled into it

90700 is a Column 1 code in 4 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.

Column 2 codeShort descriptionModifier indicator
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
90702Dt vaccine under 7 yrs im0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

90700 is bundled into these codes

90700 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 90700 is the code that denies.

Column 1 codeShort descriptionModifier indicator
90696Dtap-ipv vaccine 4-6 yrs im0Check pair
90697Dtap-ipv-hib-hepb vaccine im0Check pair
90698Dtap-ipv/hib vaccine im0Check pair
90714Td vacc no presv 7 yrs+ im0Check pair
90715Tdap vaccine 7 yrs/> im0Check pair

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.