CSHCN Services Program 2010 > Physician > Benefits, Limitations, and Authorization Requirements

   
 

30.2.23.6 Immunizations During an Office Visit

When a client is immunized during an initial or follow-up office visit for a medical condition, the office visit may be reimbursed in addition to any vaccine or toxoid not obtained through TVFC and the administration fee when an appropriate medical diagnosis is submitted with the claim.

When the client visit is only for immunization, the office visit will not be reimbursed. The administration fee and any vaccine or toxoid not obtained through TVFC may be reimbursed when an appropriate diagnosis code referencing an immunization (i.e., a "V" series diagnosis code) is submitted with the claim.


Texas Medicaid & Healthcare Partnership
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