CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Preventive care
99382 — Preventive medicine, new patient; early childhood age 1-4 years
This covers a new-patient well-child visit for toddlers and young children ages 1 through 4.
- Typical setting: Doctor's office
- National avg charge (illustrative): $130-$230 (commercial/Medicaid; Medicare does not pay preventive CPT codes for this age group)
- Most-disputed reason: Age bracket error: using 99382 for a child who is 5 or older — should be 99383 for ages 5-11
What it means
What 99382 actually means
This covers a new-patient well-child visit for toddlers and young children ages 1 through 4. The physician performs a comprehensive physical exam and provides age-appropriate anticipatory guidance on development, nutrition, safety, and immunizations. The focus is entirely on prevention, not treatment of illness.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Age bracket error: using 99382 for a child who is 5 or older — should be 99383 for ages 5-11
- Mixing preventive and problem-oriented billing: billing a separate E/M code for reviewing a known, stable issue (like mild eczema) without a genuinely distinct and separately documented problem
- New vs. established error: billing 99382 when the family has been seen in the practice within 3 years — correct code would be 99392
If you see 99382 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 99382 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 99382 on a bill.
99382 FAQ
Plain-English answers.
What does 99382 usually cost?
$130-$230 (commercial/Medicaid; Medicare does not pay preventive CPT codes for this age group). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 99382?
Age bracket error: using 99382 for a child who is 5 or older — should be 99383 for ages 5-11
What should I do if I see 99382 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 99382 before paying.
Don't pay 99382 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.