COVID-19 Vaccine Administration Procedure Code 0044A is Now a Benefit of Medicaid and CHIP

Date: November 11, 2022 Attention: All Providers Effective date: Dates of service on or after October 19, 2022Providers 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 Health Plan (TCHP) would like to inform providers that effective for dates of service on or after October 19, 2022, in accordance with the U.S. Food and Drug Administration’s (FDA) Emergency Use Authorization (EUA), COVID-19 vaccine administration code 0044A is now a benefit of Medicaid and CHIP for the administration of the Novavax booster dose to individuals 18 years of age or older. Vaccine procedure code 91304 will continue to be informational only while the vaccine is distributed to providers free of charge. COVID-19 vaccine administration code 0044A is a benefit of Medicaid and CHIP for the following providers and places of service:  

Place of Service	Provider Type
Office	Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Physician, Pharmacist, Certified Nurse Midwife (CNM), Federally Qualified Healthcare Centers (FQHCs), Nephrology (Hemodialysis, Renal Dialysis), Rural Health Clinics (RHCs), Pharmacy
Home	PA, NP, CNS, Physician, Home Health Agency, Comprehensive Care Program (CCP) Provider
Outpatient Hospitals	FQHCs, Hospitals, Nephrology (Hemodialysis, Renal Dialysis), Renal Dialysis Facility, RHCs
Other Locations	PA, NP, CNS, Physician, FQHCs, CCP Provider, RHCs

  How this impacts providers: As of October 19, 2022:

• Providers can be reimbursed for administration of Novavax booster in Medicaid and CHIP members who are 18 years of age or older using Procedure code 0044A.
• Procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure code 0044A for individuals 18 years of age or older.

Providers interested in enrolling as a COVID-19 vaccinator should visit www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx for more information. Next steps for providers: Providers are encouraged to 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