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Age Range Updates for Trivalent Influenza Vaccine Procedure Codes Effective September 1, 2024

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective for dates of service on or after September 1, 2024, the age range limitations for trivalent influenza vaccine procedure codes have been updated as follows:

Procedure CodeAge Range
906566 months of age or older
906586 months of age or older
906602 years through 49 years of age
9067318 years of age or older

Affected claims that are submitted with dates of service on or after September 1, 2024, will be reprocessed. Providers may receive additional payment, which will be reflected on future Remittance and Status (R&S) Reports.

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