Wiki Gardasil for a male patient

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liz_snyder

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Local Chapter Officer
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How would you bill Gardasil (HPV vaccine) for a male patient? Are they the same CPT codes?
We are using 90649 or 90650 plus administration and finding it difficult to get paid for these codes when the patient is male.
 
Yes the CPT code is the same for male/female patients. Alot of insurance companies are not paying for boys yet. I'm from Mass and BCBSMA is not paying for these but Tufts and Harvard are. You might want to check in your area with the big payers to see. :)
 
liz_snyder said:
How would you bill Gardasil (HPV vaccine) for a male patient? Are they the same CPT codes?
We are using 90649 or 90650 plus administration and finding it difficult to get paid for these codes when the patient is male.
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Per the FDA and CDC, effective 01/01/12, Gardisil (code 90649) will be approved for both males and females, while Cervarix (code 90650) is still only approved for females. Speaking from the insurance company perspective, we will pay for 90649 for both, and 90650 for females, of the correct age range. Other carriers, of course, will have their own policies.

Thanks,
 
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