Yellow Fever Vaccine, for Subcutaneous Use (YF-Vax®) HCPCS Code 90717 - Yellow Fever Vaccine, Live, for Subcutaneous Use: Billing Guidelines

Effective with date of service Oct. 1, 2023, NC Medicaid covers yellow fever vaccine, for subcutaneous use (YF-Vax)

Effective with date of service Oct. 1, 2023, NC Medicaid Direct and NC Medicaid Managed Care cover yellow fever vaccine, for subcutaneous use (YF-Vax) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code 90717 - Yellow fever vaccine, live, for subcutaneous use. 

Strength/Package Sizes:

  • Vaccine vial, 1 Dose supplied in a package of 5 vials. 

Yellow fever vaccine, for subcutaneous use is indicated for active immunization for the prevention of yellow fever in persons nine months of age and older in the following categories:

  • Persons Living in or Traveling to Endemic Areas: While the actual risk for contracting yellow fever during travel is probably low, variability of itineraries, behaviors and seasonal incidence of disease make it difficult to predict the actual risk for a given individual living in or traveling to a known endemic or epidemic area. Greater risk is associated with living in or traveling to areas of South America and Africa where yellow fever infection is officially reported at the time of travel and with traveling outside the urban areas of countries that do not officially report the disease but that lie in a yellow fever endemic zone.
  • Persons Traveling Internationally Through Countries with Yellow Fever: Some countries require an individual to have a valid International Certificate of Vaccination or Prophylaxis (ICVP) if the individual has been in countries either known or thought to harbor yellow fever virus. The certificate becomes valid 10 days after vaccination with YF-Vax.
  • Laboratory Personnel: Laboratory personnel who handle virulent yellow fever virus or concentrated preparations of the yellow fever vaccine virus strains may be at risk of exposure by direct or indirect contact or by aerosols. 

Recommended Dose:

  • Primary Vaccination: Administer a single subcutaneous injection of 0.5 mL of reconstituted vaccine. However, an additional dose of yellow fever vaccine may be given to individuals who might not have had an adequate or sustained immune response to prior yellow fever vaccination and who continue to be at risk for exposure to yellow fever virus. Such individuals include women who were vaccinated during pregnancy, hematopoietic stem cell transplant recipients, and HIV-infected persons.
  • Booster Vaccination: A booster dose may be given to individuals who were last vaccinated against yellow fever at least 10 years prior and who are at increased risk for yellow fever disease either because of location and duration of travel or because of more consistent exposure to virulent virus. Such individuals include travelers who plan to spend a prolonged period in endemic areas or who plan to travel to highly endemic areas such as rural West Africa, and laboratory personnel who handle virulent yellow fever virus or concentrated preparations of the yellow fever vaccine virus strains.

See full prescribing information for further detail. 

For Medicaid Billing

  • The ICD-10-CM diagnosis code required for billing is: Z23 - Encounter for immunization
  • Providers must bill with HCPCS code: 90717 - Yellow fever vaccine, live, for subcutaneous use
  • One Medicaid unit of coverage is: 0.5 mL  
  • The maximum reimbursement rate per unit is: NDC specific SMAC rate. See fee schedule for current rate.
  • Providers must bill 11-digit NDCs and appropriate NDC units. The NDCs are: 49281-0915-01, 49281-0915-58 
  • The NDC units should be reported as "UN1"
  • For additional information, refer to the January 2012, Special Bulletin, National Drug Code Implementation Update.
  • For additional information regarding NDC claim requirements related to the PADP, refer to the PADP Clinical Coverage Policy 1B, Attachment A, H.7 on NC Medicaid's website.
  • Providers shall bill their usual and customary charge for non-340B drugs.
  • PADP reimburses for drugs billed for Medicaid beneficiaries by 340B participating providers who have registered with the Office of Pharmacy Affairs (OPA). Providers billing for 340B drugs shall bill the cost that is their actual acquisition cost. Providers shall indicate that a drug was purchased under a 340B purchasing agreement by appending the "UD" modifier on the drug detail.
  • The fee schedule for the PADP is available on the NC Medicaid Fee Schedule & Covered Code portal.

ICD-10-CM Manual. American Medical Association, 2023 manual.

*Information current as of Sept. 26, 2023, and is not a substitute for professional judgment. For full prescribing information, please refer to current package insert or other appropriate sources prior to making clinical judgments.


NCTracks Call Center: 800-688-6696 

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