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When VFC supplies the vaccine at no cost, the administration is still billable under 90471, but you need modifier SL to flag the vaccine as state-supplied

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To eliminate a violation of the 2 times rule and improve clinical and resource homogeneity in the APCs for which we did not propose a 2 times rule exception, we proposed to reassign these procedure codes to new APCs that contain services that are similar with regard to both their clinical and resource characteristics

Patients with neurological symptoms require more intensive treatment with alternate-day injections until improvement plateaus, and may need more frequent maintenance dosing