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Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
After becoming aware of the severe impact that influenza infections are having on pregnant women and their babies in Florida, Florida Medicaid has temporarily activated payment for CPT code 90686 for Medicaid recipients who are pregnant and age 21 and older; in addition to the current coverage for ages 0-20.
The reimbursement rate will be the same as those vaccines that are covered for Medicaid recipients between the ages of 18-20, and will be effective for dates of service between and including December 19, 2013 through March 31, 2014.
Please note that this code will only be activated for Medicaid enrolled pregnant women, which requires a pregnancy diagnosis on the claim.
Source: Florida Medicaid Health Care Alert - December 2013
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