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Influenza Vaccination Information
Information posted September 18, 2009: Influenza vaccine is available through the Texas Vaccines for Children (TVFC) program free of charge for Texas Medicaid clients who are birth through 18 years of age. Influenza vaccine is a benefit of Texas Medicaid for high-risk clients of any age when the client is not covered by THSteps or TVFC, or when the vaccine is not available through TVFC. Providers are expected to follow Advisory Committee on Immunization Practices (ACIP) recommendations that relate to the prevention and control of influenza. Texas Medicaid does not require providers to enroll in TVFC; however, reimbursement for influenza vaccination administered to clients who are birth through 18 years of age is denied if the vaccine is available through TVFC, even if the provider is not enrolled in TVFC. Click on the title to view the details.

Providers are not reimbursed for the vaccine through Texas Medicaid. Providers must not bill the client for influenza vaccine that is available through TVFC. Any physician, physician’s assistant, nurse practitioner, or certified nurse midwife may enroll in TVFC regardless of their type of practice. A provider enrolled in TVFC is not required to provide the full range of childhood immunizations and may opt to give only seasonal influenza vaccine.

More information about TVFC, including an enrollment application, can be found on the TVFC website at www.dshs.state.tx.us/immunize/tvfc/default.shtm.

Providers are expected to follow Advisory Committee on Immunization Practices (ACIP) recommendations that relate to the prevention and control of influenza. This information can be found on the ACIP website at www.cdc.gov/vaccines/recs/acip/default.htm.

Reimbursement of the administration fee through Texas Medicaid may be considered when providers bill the appropriate administration and influenza vaccine procedure codes. Providers may refer to the 2009 Texas Medicaid Provider Procedures Manual, Appendix H, “Immunizations,” and section 36.4.20.5, “Influenza Vaccine.” for additional information.

 

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