Emily Lomaquahu, CPC, CPMA, CEDC
Senior Coding Quality Auditor & Educator
Emily is a Senior Coding Quality Auditor for Haugen Consulting Group and brings over a decade of experience to the profee team! She began her career as an auditor and with her keen eye for detail, she quickly found it was a perfect fit. Emily thrives in a collaborative environment and enjoys creating high-quality trainings to help providers and coders navigate charts and improve their accuracy. She earned a bachelor’s degree from the University of Colorado, in Denver. Emily specializes in Evaluation and Management (E/M), Primary Care, Anesthesia, Emergency Department, and Neurology, though she says Anesthesia and Neurology are her favorites! She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), and Certified Emergency Department Coder (CEDC).
Have you ever seen an encounter note in which your provider spends time talking through vaccines with a patient—answering questions, addressing hesitations, and explaining risks and benefits—only to have the patient say, “I’ll think about it?”
CPT is attempting to acknowledge this work with new codes effective January 1, 2026. These codes may allow providers to report time spent on vaccine counseling when the vaccine is not given on the same day. That’s a big deal, especially for those longer conversations around vaccine hesitancy.
These codes apply when a provider educates or counsels a patient about a specific vaccine, but the patient ultimately decides to delay or decline the immunization.
The codes:
90482 – Vaccine counseling when vaccine is not given on the same DOS, 3–10 minutes
90483 – greater than 10–20 minutes
90484 – greater than 20 minutes
Before getting too excited, there’s an important caveat: CMS has assigned these codes a status indicator of “I.” That means they are not valid for Medicare payment.
That said, commercial payors are a different story. Some may choose to recognize and reimburse these services, so it will be important to check individual payer policies.
Clear documentation will be important for reporting. The medical record should:
- Indicate which vaccine(s) were counseled on
- Reflect that the vaccine was not administered on the same date of service
- Include the total time spent providing vaccine counseling
If counseling is provided for multiple vaccines and none are administered, add the time together and report one code based on total time.
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