CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Preventive care
99383 — Preventive medicine, new patient; late childhood age 5-11 years
This is the new-patient preventive well visit code for school-age children from 5 to 11 years old.
- Typical setting: Doctor's office
- National avg charge (illustrative): $130-$230 (commercial/Medicaid; not covered by Medicare for this age group)
- Most-disputed reason: Age bracket overlap: billing 99383 for a child who turned 12 — the correct code is 99384 for ages 12-17
What it means
What 99383 actually means
This is the new-patient preventive well visit code for school-age children from 5 to 11 years old. The physician conducts a comprehensive history and physical, reviews immunization status, screens for developmental and behavioral concerns, and provides counseling on nutrition, activity, and safety.
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 overlap: billing 99383 for a child who turned 12 — the correct code is 99384 for ages 12-17
- Established patient error: using new-patient code 99383 when the child has been seen by any provider in the practice group within the past 3 years
- Vaccine unbundling issues: incorrectly bundling or separately billing vaccine administration codes that should be billed in addition to the preventive visit
If you see 99383 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 99383 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 99383 on a bill.
99383 FAQ
Plain-English answers.
What does 99383 usually cost?
$130-$230 (commercial/Medicaid; not covered by Medicare 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 99383?
Age bracket overlap: billing 99383 for a child who turned 12 — the correct code is 99384 for ages 12-17
What should I do if I see 99383 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 99383 before paying.
Don't pay 99383 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.