Is it covered? 39 pediatric codes, answered for the front desk.
Well visits, vaccines and screenings are usually free to the family, right up until a sick visit rides on the same day. These pages explain each code and the coverage rule behind it.
Vaccines
- 90471: Is the fee for giving a shot covered by insurance?
- 90715: Is the Tdap shot covered by insurance for teens?
- 90651: Is the HPV vaccine covered by insurance for teens?
- 90472: Are extra vaccine shots at the same visit covered?
- 90460: Are childhood vaccines covered by insurance?
- 90734: Is the meningitis shot for teens covered by insurance?
- 90461: Is the extra fee for a combination shot covered by insurance?
- 90380: Is the RSV shot for babies covered by insurance?
Screenings
- 96127: Is ADHD or depression screening covered by insurance?
- 99173: Is a vision screening at a checkup covered by insurance?
- 96110: Is developmental screening covered by insurance?
- 96160: Is a health risk questionnaire covered by insurance?
- 92551: Is a hearing test at a checkup covered by insurance?
- 96161: Is postpartum depression screening at a baby's visit covered?
- 99177: Is the vision screening camera covered by insurance?
Well visits
- 99395: Is a yearly physical covered by insurance?
- 99391: Is my baby's well visit covered by insurance?
- 99392: Are toddler well visits covered by insurance?
- 99381: Is a newborn's first office visit covered by insurance?
- 99394: Is a teen well visit or sports physical covered by insurance?
- 99384: Is a new patient teen physical covered by insurance?
- 99393: Is a school-age well visit covered by insurance?
Preventive care
Also billed in pediatric
These codes are common in pediatric too. Each has one page in the guide that owns it.
- G2211: Is the G2211 visit add-on covered by insurance?
- 17110: Is getting a wart removed covered by insurance?
- 11750: Is ingrown toenail surgery covered by insurance?
- 10060: Is draining a cyst or abscess covered by insurance?
- 10040: Is having acne cysts drained covered by insurance?
- 99214: Is a longer urgent care visit covered by insurance?
- 99213: Is an urgent care visit covered by insurance?
- 99204: Is a longer first urgent care visit covered by insurance?
- 99203: Is my first visit to urgent care covered by insurance?
- 36415: Is a blood draw at urgent care covered by insurance?
- 99212: Is a quick urgent care visit covered by insurance?
- 99211: Is a nurse-only visit covered by insurance?
- 96372: Is a shot at urgent care covered by insurance?
- 99385: Is a physical at urgent care covered by insurance?
- 69210: Is ear wax removal covered by my insurance?
- 12001: Are stitches at urgent care covered by insurance?
- 87804: Is a flu test at urgent care covered by insurance?
- 81002: Is a urine test at urgent care covered by insurance?
- 87880: Is a rapid strep test covered by insurance?
- 10120: Is splinter removal covered by insurance?
- 87426: Is a COVID test at urgent care covered by insurance?
- 94640: Is a breathing treatment covered by insurance?
- 12011: Are stitches on the face covered by insurance?
- 29125: Is a wrist or forearm splint covered by insurance?
- 99051: Is the after-hours fee at urgent care covered?
- 87428: Is a combined flu and COVID test covered by insurance?
- 15853: Is getting stitches removed covered by insurance?
- 99202: Is a first chiropractic visit covered by insurance?
Every pediatric patient, verified before they check in.
Plan status, deductible left, copay and coinsurance, read off the actual plan in under a second. First month free, then $2.50 a check.
Other guides: Dermatology · Urgent care · Chiropractic · Dental (CDT)
CPT is a registered trademark of the American Medical Association. The explanations on these pages are Valian's own plain-English summaries for front-desk teams, not official CPT descriptor text, and are not billing or clinical advice. Coverage patterns describe common plan behaviors; every plan differs. Verify benefits before the visit.