90633 CPT® code: payer coverage and prior authorization90633 appears in 4 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, BlueCross BlueShield of South Carolina.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Hepatitis A Vaccine (0048) | covered if criteria are met | Mar 11, 2026 | payer document |
| Aetna | Injectable Medications (0020) | listed, no stance (range 90581-90658) | Mar 5, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Immunizations Adult and Pediatric | covered if criteria are met | Jun 9, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Preventive Services for Non-Grandfathered (PPACA) Plans: Immunizations (CAM 109) | listed, no stance | Apr 1, 2026 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.