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?
Verify every pediatric patient in one click, before they check in.
Plan status, deductible left, copay and coinsurance, read off the actual plan in seconds. Plans from $39 a month per location, billed yearly, or from $49 month to month. Plus $2.50 or less per check we find — $0 when we can’t find the insurance. No setup fee and no seat fees.
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.