Immunization Rules



For Members



  • Immunization is one of the most cost-effective health preventive measure.
  • Vaccines are given to build immunity and defense against infections and infectious diseases.
  • Vaccines are safe and effective.
  • Immunization also slows down or stops disease outbreaks and improves quality of life for societies.
  • Some vaccines are effective for lifetime after one (1) dose (e.g. BCG), some require repetitive administrations at prescribed intervals (e.g. Polio) whereas some vaccines require boosters regularly (e.g. Hepatitis-B).
  • Administration of vaccine require prior approval from Nextcare.
  • All children should receive Vaccination.


Dubai (DHA) Policy:

  • Vaccine and vaccine administration services for infants & children up to age of 6 Years are generally covered under DHA compliant policies.
  • Below schedule is followed based on the recommendation of the Dubai Health Authority (DHA):
  • Other vaccines which are not mentioned in the below schedule are not covered.


DHA immunization schedule for children between 0-6 years
Age Vaccines
At Birth BCG, Hep B.
Two months DPT, Hib, Hep B, OPV, PCV.
Four months DPT, Hib, Hep B, OPV, PCV.
Six months DPT, Hib, Hep B, OPV, PCV.
12 months MMR, varicella
18 months DTaP, Hib, OPV, PCV.
Five to six years DPT, OPV, MMR, varicella.


Reference for DHA:


Abu Dhabi (DOH) Policy:
Vaccine and vaccine administration services are mostly Excluded under DOH compliant policies.


Northern Emirates (Non-DHA & Non-DOH Policies):
Vaccine and vaccine administration services are covered according to the table of benefits respective to every policy, please always call Nextcare to check if vaccines are covered.



For Healthcare Providers


  • To correctly report vaccine counselling and administration with these codes, it is important to recognize what the codes are include.
  • These codes are limited to immunization administration only.
  • Any purchased vaccine products must be separately
  • Cost of Vaccine/s is not a part of the Pharmacy limit.
CPT Description
90460 This Code is used when a Physician is present and performs face-to-face counselling to the patient and/or parent. This code can only be used for patients up-to the age of 18.
90461 Following each additional vaccine/toxoid component administered , this code is additionally reported along with code 90460
90471 This Code is used when the vaccine/toxoid component is administered by a medical assistant or nurse and the patient does not see the physician at all.
90472 Following each additional vaccine/toxoid component administered, this code is additionally reported along with code 90471
  • A face-to-face service where a Physician or other qualified healthcare professional (qualified per Emirate`s Licensing Authority) provides counselling to the patient (patients under 18 years of age and below) and/or to parent, it is required to report 90460-90461.
  • In the absence of counselling, the administrations must be reported with codes 90471-90474.
  • Code 90460 is reported for each separate administration of single component vaccines and/or first component of a combination vaccine.
  • When reporting administration of combination vaccines, code 90460 is reported for the first component and add-on code 90461 is reported for each additional component (modifier-51 is not required).
  • All above mentioned codes include “via any route of administration”, that is; regardless of the route of administration (e.g. Subcutaneous, Intramuscular, Injection, Oral, or Intranasal).