TMPPM 2011 > Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook > Physician > Services/Benefits, Limitations, and Prior Authorization > Immunizations for Clients Birth through 20 Years of Age > Vaccine Coverage Through the TVFC Program

8.2.34.1 Vaccine Coverage Through the TVFC Program

The TVFC Program provides vaccines and toxoids for Texas Medicaid clients who are birth through 18 years of age according to the Recommended Childhood Immunization Schedule approved by the following:

•ACIP

•American Academy of Pediatrics (AAP)

•American Academy of Family Physicians (AAFP)

Providers may refer to the TVFC web site at www.dshs.state.tx.us/immunize/tvfc/default.shtm for more information and for a list of vaccines available through the program.

Note: TVFC program resolutions do not always match the ACIP's general usage recommendations, but rather represent the rules that providers must follow when administering each specific vaccine under the TVFC.

When a single antigen vaccine or toxoid or a comparable antigen vaccine or toxoid is available through TVFC, but the provider chooses to use a different ACIP-recommended product, the administration fee will be reimbursed but the vaccine or toxoid will not be reimbursed.

Although Texas Medicaid does not mandate that providers enroll in TVFC, Texas Medicaid will not reimburse providers when the vaccine is available through TVFC. Only the administration fee will be reimbursed through Texas Medicaid when the vaccine or toxoid procedure code is identified on the claim. Clients may not be billed for vaccines and toxoids that are available through TVFC.

Refer to: Subsection 5.1.3, "Texas Vaccines for Children (TVFC) Program," in Children's Services Handbook (Vol. 2, Provider Handbooks) for additional information about TVFC and immunizations for infants and children.