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Commissioner Approved Fee Schedule - FY 2019-20 <br />* Any fee changes will be included in this column; <br />a blank beside each fee means there is no fee change in FY 2019-20 Commissioner Approved Fee Schedule <br />Department/Program Description Current Fee <br />Commissioner Approved <br />Fee Change for <br />FY 2019-20* <br />Last <br />Revision <br />90700 <br />Diphteria, tetanus toxoids, and acellular pertussis <br />vaccine (DTaP), for 7 years or younger - <br />DAPTACEL $30.00 2019 <br />Medicaid only <br />90700SL <br />Diphteria, tetanus toxoids, and acellular pertussis <br />vaccine (DTaP), for 7 years or younger - <br />DAPTACEL $0.00 2019 <br />90700 <br />Diphteria, tetanus toxoids, and acellular pertussis <br />vaccine (DTaP), for 7 years or younger - <br />INFANRIX $32.00 2018 <br />Medicaid only <br />90700SL <br />Diphteria, tetanus toxoids, and acellular pertussis <br />vaccine (DTaP), for 7 years or younger - <br />INFANRIX $0.00 2019 <br />90702 Diptheria tetanus toxoid absorbed < 7yr IM $40.00 Delete fee 2015 <br />90707 Measles, mumps, and rubella virus vaccine <br />(MMR), live - M-M-R II $66.00 $101.00 2019 <br />Medicaid only 90707SL Measles, mumps, and rubella virus vaccine <br />(MMR), live - M-M-R II $0.00 2019 <br />90713 Poliovirus vaccine (IPV), inactivated - IPOL $31.00 $34.00 2019 <br />Medicaid only 90713SL Poliovirus vaccine (IPV), inactivated - IPOL $0.00 2019 <br />67