CHIP Coverage of Monkeypox Testing and Vaccines

Date: December 13, 2022

Attention: All Providers

Effective date: Dates of service on or after July 26, 2022

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that Monkeypox testing and vaccines are a covered benefit in CHIP effective for dates of service on or after July 26, 2022.

How this impacts providers: CHIP coverage of Monkeypox testing and vaccines can be covered under CHIP outpatient hospital, clinic, and physician services.

Related Healthcare Common Procedure Coding System (HCPCS) codes include:

• Monkeypox laboratory test-87593
• Monkeypox vaccines- 90611 and 90622

Claims submitted will be automatically reprocessed by TCHP for appropriate payment to providers. Providers do not need to submit appeals unless they are denied for other reasons after the claims reprocessing is complete.

Next steps for providers: Providers should share this communication with their staff.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers