Effective for dates of service on or after June 17, 2022, in accordance with the U. S. Food and Drug Administration (FDA) amendment to the Emergency Use Authorization (EUA), COVID-19 vaccine administration codes 0011A, 0012A, and 0013A are benefits of Medicaid and CHIP for the administration of the Moderna COVID-19 vaccine for individuals 12 years of age and older.
HHSC will continue to cover procedure codes 0011A, 0012A, and 0013A as non-risk payments.
Vaccine procedure code 91301 is informational only while the vaccine is distributed to providers free of charge.
As of June 17, 2022, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed int eh home setting with procedure code 0011A, 0012A, and 0013A for individuals 12 years of age and older.
Community First must reprocess affected claims submitted with these procedure codes and date of service on or after June 17, 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 codes 0011A, 0012A, and 0013A for individuals 12 years of age an older.
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 the Provider Relations division by phone at (210) 358-6294 or by email at ProviderRelations@CFHP.com.