Effective for dates of service on or after March 14, 2023, in accordance with the U.S. Food and Drug Administration’s amended Emergency Use Authorization, COVID-19 vaccine administration procedure code 0174A for the administration of the Pfizer-BioNTech COVID-19 vaccine booster is now a benefit of Texas Medicaid and CHIP for individuals 6 months through 4 years of age.
The Texas Health and Human Services Commission (HHSC) will cover procedure code 0174A as a non-risk payment.
Vaccine procedure code 91317 will continue to be informational only while the vaccine is distributed to providers free of charge.
Procedure code 0174A is a benefit of Medicaid and CHIP for the following providers and places of service:
As of March 14, 2023, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure code 0174A for individuals 6 months through 4 years of age.
Providers in MCO networks interested in enrolling as a COVID-19 vaccinator should visit www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx for more information.
Resources:
Community First Resources:
Contact:
Email ProviderRelations@cfhp.com or call 210-358-6294.