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24.3.20.4 Authorization Requirements for Immunizations (Vaccines/Toxoids)
Authorization is not required for the administration of vaccines/toxoids obtained from the TVFC Program. Providers enrolled in the TVFC are responsible for determining the eligibility of clients to receive TVFC services.
Authorization is required for vaccines/toxoids administered when both of the following conditions are met:
• The provider has purchased the vaccine.
•The provider is not enrolled in the TVFC Program, or the client does not meet the TVFC criteria.
This information must be documented when requesting authorization. Authorization must be obtained from TMHP.
Prior authorization is required for any vaccine/toxoid not listed in the table. Providers must submit prior authorization requests to TMHP-CSHCN Services Program with documentation of medical necessity for the requested vaccine/toxoid.
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