Healthcare professionals, medical billers, and coders rely heavily on accurate shingles vaccination coding. Many practices experience claim denials, delayed reimbursements, or compliance issues, which lead to failing to submit the correct CPT code or providing missing information.
The Centers for Disease Control and Prevention (CDC) recommends two doses of the recombinant zoster vaccine (RZV), Shingrix, for individuals aged 50 and older in 2026 to prevent shingles and its associated sequelae. Despite this advice, immunization rates remain low. By 2022, just 36% of persons aged 50 and older and 43.8% of those aged 60 and older had received at least one dose of the herpes zoster vaccination. This highlights the importance of accurate billing and coding in ensuring equitable remuneration and promoting immunization initiatives.
In this blog, we will discuss the CPT codes for shingles vaccines, explain when and how to use them, and provide advice for ensuring claims are handled successfully. You’ll also learn about the benefits of using the correct codes, such as easier reimbursements and a lower risk of denials.
What is the Shingles Vaccine? (Shingles Vaccine CPT Code)
This section defines the vaccination and its CPT code. It assists providers in using the correct code and improves billing clarity.
Shingrix (CPT 90750)
As of 2026, the CDC exclusively recommends the Shingrix vaccine for the treatment of shingles. It is a two-dose recombinant zoster vaccine provided two to six months apart. For each dose, you must bill CPT 90750.
- Effectiveness: According to the CDC (2026), Shingrix is more than 90% effective in preventing shingles and postherpetic neuralgia in persons aged 50 and over.
- Eligibility: Recommended for all individuals over the age of 50, as well as immunocompromised young people aged 19 and up.
- Coverage: Most private insurance and Medicare Part D cover Shingrix. Patients may have copayments, depending on their coverage.
- Billing Tip: To ensure proper reimbursement, always couple 90750 with an administrative code (such as 90471 or 90472).
Zostavax (CPT 90736): Legacy Code
Zostavax was a live attenuated shingles vaccine known as CPT 90736. However, it was withdrawn in the United States in November 2020 and will no longer be accessible for usage by 2026.
Historical Use: Previously delivered as a single-dose immunization to individuals aged 60 and over.
Effectiveness: Clinical data showed that Zostavax was approximately 51% effective in reducing shingles cases, which was lower than SHINGRIX.
Current Status (2026):
- The CDC no longer recommends Zostavax.
- If clinicians come across CPT 90736 on older claims or in patient records, they should treat it as a legacy code exclusively.
Billing Consideration: 90736 should no longer be used for billing purposes; however, it may still appear in historical patient records or when examining earlier claims.
Shingles Vaccine CPT Codes
This section identifies the appropriate CPT codes for the shingles vaccine. Using the incorrect code might result in denials, delays, and compliance issues.
Common CPT Codes for Shingles Vaccine
The two main CPT codes for shingles vaccines are 90750 for Shingrix (now recommended) and 90736 for Zostavax.
| CPT Code | Description | When Used |
| 90736 | Zoster (shingles) vaccine, live, subcutaneous injection | Used for the Zostavax vaccine (live attenuated), though it is rarely used now due to limited availability in the U.S. |
| 90750 | Recombinant zoster vaccine, adjuvanted, intramuscular injection | Used for Shingrix, the current CDC-recommended shingles vaccine, commonly administered in two doses. |
| 90471 | Immunization administration (first vaccine or toxoid given via any route) | Reported when the shingles vaccine is the only vaccine administered during the visit. |
| 90472 | Each additional vaccine administration (after the first) | Reported if the shingles vaccine is given in the same visit as other vaccines. |
| 90460 / 90461 | Immunization administration through 18 years of age, with counseling by a physician or qualified health professional | Rarely applied for shingles vaccine, as shingles vaccines are for adults; may use if given in pediatric settings for special cases. |
Billing Guidelines for Shingles Vaccine
Billing the shingles vaccination requires precise CPT coding, administration reporting, and payer-specific documentation. Errors frequently result in denials; therefore, providers are required to stick to proper coding and billing rules.
Vaccine CPT Codes
CPT codes for shingles vaccines are required for proper invoicing and reimbursement. They indicate the precise vaccine administered and help to avoid claim denials.
The most commonly used vaccination CPT codes for shingles are 90750 for Shingrix and 90736 (legacy Zostavax). Correct selection ensures that payer rules are followed and revenue is accurately captured.
Administration CPT Codes
Administration CPT codes describe the professional service of providing the shingles vaccination, not the product itself. These codes address counseling, preparation, and injection.
Common codes include 90471 for the first vaccination and 90472 for each following dose. When used correctly, these ensure proper reimbursement and compliance.
When to Use Each CPT Code
The appropriate code depends on whether you are billing for the vaccine product, the administration, or both. Product codes represent the vaccination, whereas administration codes identify the clinical service.
Providers should always consult payer policies, as some require both codes for full payment. Using the incorrect code combination frequently results in claim denials.
Conclusion
The correct use of shingles vaccination CPT codes is essential for avoiding billing problems, minimizing denials, and providing proper compensation. Shingrix, billed with CPT 90750, remains the only CDC-recommended choice in 2026, with 90736 only appearing in historical claims. Administration codes 90471 and 90472 must be used accurately to indicate the healthcare service provided. Consistent adherence to payer criteria increases compliance and facilitates immunization access for eligible patients. Healthcare teams can secure revenue cycles while also contributing to public health goals through employing the proper coding strategies.
FAQs
What is the CPT code for the Shingrix shingles vaccine?
The CPT code for Shingrix, the recombinant zoster vaccine, is 90750.
How should the shingles vaccine be billed?
Bill the vaccine using 90750 along with the appropriate administration code, such as 90471.
Does Medicare cover the shingles vaccine?
Yes, Medicare Part D covers Shingrix, but it is not covered under Part B.
What are common billing errors for shingles vaccine claims?
Frequent errors include missing administration codes, incorrect diagnosis codes, or billing under Medicare Part B.
What ICD-10 code is used with the shingles vaccine?
The most common diagnosis code is Z23 for “encounter for immunization.
