Some COVID-19 Vaccine Procedure Codes No Longer a Benefit of Texas Medicaid & CHIP

Date: September 23, 2024
Attention: Providers
Effective date: October 1, 2024

Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after October 1, 2024, some COVID-19 vaccine administration procedure code benefits will no longer be a be benefit for Texas Medicaid and CHIP. These changes reflect the discontinued coverage of COVID-19 vaccines that do not have full approval by the U.S. Food and Drug Administration (FDA) by the end of the American Rescue Plan Act (ARPA) period.

How this impacts providers: The following COVID-19 vaccine procedure codes will no longer be a benefit

The following COVID-19 vaccine procedure codes will continue to be a benefit as they have full approval from the FDA:

Next step for Providers: Providers are encouraged to share this communication with their staff.Providers may still obtain all available vaccines recommended by the Advisory Committee on Immunization Practices for children (birth through 18 years of age) at no cost from the Texas Vaccines for Children (TVFC) Program. More information about the TVFC Program can be found at https://www.dshs.texas.gov/immunizations/providers/overview.

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

For access to all provider alerts:https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.