Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, 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.
Beginning November 10, 2022, for dates of service on or after October 19, 2022, the Texas Medicaid & Healthcare Partnership will implement reimbursement rates for COVID-19 vaccine administration procedure code 0044A (Novavax vaccine administration booster for adults 18 years and older) for Texas Medicaid, Healthy Texas Women (HTW), the Family Planning Program (FPP), and the Children with Special Health Care Needs (CSHCN) Services Program.
TMHP will reprocess any affected claims that are identified. Providers are not required to appeal the claims unless the claims are denied for additional reasons after reprocessing is completed.
To view the updates, click the following link COVID-19 vaccine administration procedure code 0044A.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.