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COVID-19 Vaccine Administration Procedure Codes 0011A and 0012A Are Now Benefits

Last updated on 12/21/2020

Effective December 18, 2020, in accordance with the Food and Drug Administration’s issuance of Emergency Use Authorization for the Moderna COVID 19 Vaccine, vaccine administration procedure codes 0011A and 0012A are benefits for Medicaid, Healthy Texas Women, Family Planning Program, and the Children with Special Health Care Needs Services Program for individuals who are 18 years of age and older. Vaccine procedure code 91301 is informational only while the vaccine is distributed to providers free of charge.

Procedure codes 0011A and 0012A are benefits for the following providers and places of service:

Medicaid and HTW Places of Service

Provider Type

Office

Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, Certified Nurse Midwife, Pharmacist, CCP Provider, Nephrology (Hemodialysis, Renal Dialysis), Pharmacy, Clinic/Group Practice, Licensed Midwife, Registered Nurse, County Indigent Health Care Program

Outpatient Hospital

Nephrology (Hemodialysis, Renal Dialysis), Hospital Providers, Renal Dialysis Facility

Home

Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, CCP Provider, Clinic/Group Practice

Other Locations

Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, CCP Provider, Clinic/Group Practice, County Indigent Health Care Program

CSHCN Place of Service

Provider Type

Office

Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, Pharmacist, CCP Provider, Nephrology (Hemodialysis, Renal Dialysis), Pharmacy

Outpatient Hospital

Nephrology (Hemodialysis, Renal Dialysis), Hospital Providers, Renal Dialysis Facility

Home

Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, CCP Provider

Other Locations

Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, CCP Provider

Providers should reference the table below when submitting claims for vaccine administration:

Vaccine Code

Vaccine Administration Codes

Labeler Name

Administration Interval

91301

0011A (first dose)

Moderna

28 days

0012A (second dose)

Providers interested in enrolling as a COVID-19 vaccinator should visit www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx for more information.

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