Texas Children's Health Plan will be closed on Friday, July 4th, in observance of Independence Day. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Monday, July 7th. Wishing you a safe and happy Independence Day!
Texas Children's Health Plan estará cerrado el viernes 4 de julio por el Día de la Independencia. Durante este tiempo, puede comunicarse con nuestra línea de ayuda disponible las 24 horas, los 7 días de la semana, al 1-800-686-3831. Reanudaremos nuestro horario habitual el lunes 7 de julio. ¡Le deseamos un feliz y seguro el Día de la Independencia!
Cold and flu seasonTemporada de influenza y resfriados
ALERT:Stay healthy this cold and flu season!Learn more
ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados!Más información
COVID-19 Vaccine Administration Procedure Codes 0164A and 0173A are Now Benefits of Medicaid and CHIP
Date: February 10, 2023
Attention: All Providers
Effective date: Dates of service on or after December 8, 2022
Providers 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 inform providers that effective for dates of service on or after December 8, 2022, in accordance with the U.S. Food and Drug Administration’s amended Emergency Use Authorizations, COVID-19 vaccine administration codes 0164A (Moderna) and 0173A (Pfizer-BioNTech) are now benefits of Medicaid and CHIP for administration of the following:
Moderna COVID-19 bivalent booster vaccine to individuals 6 months through 5 years of age
Pfizer-BioNTech COVID-19 bivalent booster vaccine to individuals 6 months through 4 years of age
How this impacts providers: Vaccine procedure codes 91316 (Moderna) and 91317 (Pfizer-BioNTech) are informational only while the vaccine is distributed to providers free of charge.
Procedure codes 0164A and 0173A are benefits of Medicaid and CHIP for the following providers and places of service:
As of December 8, 2022, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure codes 0164A or 0173A for individuals 6 months through 5 years of age or 6 months through 4 years of age, respectively.
Next steps for providers:Providers should share this communication with their staff. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.
