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COVID-19 Vaccine Administration Procedure Code 0031A is Now a Benefit

Last updated on 3/5/2021

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Effective February 27, 2021, in accordance with the Food and Drug Administration’s issuance of Emergency Use Authorization for the Janssen COVID‑19 Vaccine, vaccine administration procedure code 0031A is a benefit for Medicaid, Healthy Texas Women (HTW), Family Planning Program (FPP), and the Children with Special Health Care Needs (CSHCN) Services Program for individuals 18 years of age and older. Vaccine procedure code 91303 is informational only while the vaccine is distributed to providers free of charge.

Procedure code 0031A is a Medicaid and HTW benefit for the following providers and places of service:

Place 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, Registered Nurse

Home

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

Outpatient Hospital

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

Other Locations

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

Procedure code 0031A is a CSHCN Services Program benefit for the following providers and places of service:

Place of Service

Provider Type

Office

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

Home

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

Outpatient Hospital

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

Other Locations

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

Providers interested in enrolling as COVID-19 vaccinators should visit https://www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.