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COVID-19 Vaccine and Vaccine Administration Updates for Texas Medicaid Effective October 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 October 1, 2024, some COVID-19 vaccine and vaccine administration procedure code benefits will change for Texas Medicaid. These changes reflect the ending of certain American Rescue Plan Act of 2021 health care coverage provisions on September 30, 2024.

The following COVID-19 vaccine administration procedure codes will no longer be reimbursed to dental providers:

Procedure Codes
D1701D1702D1703D1704D1708D1709D1710
D1711D1713D1714    

The following COVID-19 vaccine and administration procedure codes will no longer be reimbursed to home health agency providers:

Procedure Codes
90480913189131991320913219132291304
M0201      

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