Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Code 90461

Date: November 22, 2022 Attention: All Providers                Subject: Effective date: September 1, 2022Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware that the physician administered drug vaccines and toxoids administration procedure code 90461 is no longer payable, effective September 1, 2022. How this impacts providers: Providers should follow section 9.2.35 of the Immunization Guidelines and Administration in the Texas Medicaid Provider Procedures Manual (TMPPM) available here, https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2022/2022-11-november/2_Med_Specs_and_Phys_Srvs.pdf. Next steps for providers: Providers should share this communication with their billing staff. If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers