Effective for dates of service on or after October 29, 2021, COVID-19 vaccine administration
add-on procedure code M0201 is a benefit for clients 5 years of age or older for Texas Medicaid
and CHIP.
Procedure code M0201 is an add-on procedure code for use when a COVID-19 vaccine is
administered in the home setting, and it must be billed with one other COVID-19 vaccine
administration code (0001A, 0002A, 0003A, 0004A, 0011A, 0012A, 0013A, 0031A, 0034A,
0051A, 0052A, 0053A, 0054A, 0064A, 0071A, 0072A, or 0073A)
Procedure code M0201 is a benefit for the following Providers and Places of Service:
MCOs must reprocess affected claims submitted with the procedure code and date of service
on or after October 29, 2021. 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 M0201 for individuals 5 years of
age and older. MCOs should waive the 95-day filing deadline for any claims that were not
submitted prior to this notification.
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.
For additional information, please contact Provider Relations at (210) 358-6294 or email
ProviderRelations@CFHP.com.