05/14/2024
What’s New
Effective for dates of service on or after April 1, 2024, the vaccine procedure code 90623, is now available through the Texas Vaccines for Children program for individuals 10 years through 18 years of age.
Reimbursement
Note: The above vaccines distributed by the Texas Vaccines for Children (TVFC) Program are processed as informational only on Texas Medicaid fee-for-service claims for individual who are 10 years through 18 years of age. However, these procedure codes are reported for the administration of the vaccine, which allows the provider to be reimbursed for the administration service.
Claims Reprocessing
Claims with procedure codes 90623 with dates of service from April 1, 2024, must be reprocessed for appropriate payment. We do not require providers to submit an appeal unless they are denied for other reasons after the claims reprocessing is complete.
Action
We will update our systems and processes to reflect code updates and will inform impacted providers in our network about any code updates and reprocessing of claims.
Questions
Providers, for questions or additional information, please:
- Contact your Medicaid Provider Network Representative 1-855-212-1615
- Submit via email Texas Medicaid Network Department
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.