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Reimbursement Rate Changes and Updates for RSV Vaccine Procedure Code 90678 Effective March 1, 2024

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective for dates of service on or after March 1, 2024, reimbursement rate changes and updates for respiratory syncytial virus (RSV) vaccine procedure code 90678 that was presented at the public rate hearing on February 5, 2024, will be implemented for Texas Health Steps.

To view the updates, access the Respiratory Syncytial Virus (RSV) Vaccine Procedure Code 90678 spreadsheet.

For more information, call the TMHP Contact Center at 800-925-9126.