Effective for dates of service on or after March 29, 2022, in accordance with the U.S. Food and Drug Administration amendment to the Emergency Use Authorization, MCOs must add COVID-19 vaccine administration code 0094A for the administration of the booster dose of the Moderna COVID-19 vaccine to individuals 18 years of age and older. HHSC will cover procedure code 0094A as a non-risk payment.
Vaccine procedure code 91309 is informational only while the vaccine is distributed to providers free of charge.
Procedure code 0094A is a Medicaid and CHIP benefit for the following providers and places of service:
As of March 29, 2022, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure code 0094A.
MCOs must reprocess affected claims submitted with the procedure code and date of service on or after March 29, 2022. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete. Providers may bill MCOs retroactively for COVID-19 vaccine administration code 0094A for individuals 18 years of age and older.
Providers interested in enrolling as a COVID-19 vaccinator should visit www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx for more information.
For additional information, please contact the Provider Relations division at (210) 358- 6294 or ProviderRelations@CFHP.com.