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COVID-19 Vaccine Administration Procedure Code M0201 Now a Benefit

Last updated on 9/16/2021

Effective August 24, 2021, for dates of service on or after June 8, 2021, COVID-19 vaccine administration add-on procedure code M0201 is now a benefit of Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.

Procedure code M0201 is an add-on procedure code for use when a COVID-19 vaccine is administered in the home setting and is the only service provided in the same home on the same date. Procedure code M0201 must be billed with one other COVID-19 vaccine administration code (0001A, 0002A, 0003A, 0011A, 0012A, 0013A, or 0031A).

Procedure code M0201 is a benefit for Medicaid and the CSHCN Services Program for the following providers and places of service:

Place of Service

Provider Type

Home

Physician, Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Clinic/Group Practice, Home Health Agency, CCP Provider

Affected claims with dates of service on or after June 8, 2021, will be reprocessed, and providers may receive additional payment. Additional payments will be reflected on future Remittance and Status (R&S) Reports. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.

Providers interested in enrolling as a COVID-19 vaccinator should visit 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.