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
Reimbursement for COVID-19 Vaccines for FQHCs and RHCs Reminder
Date: July 13, 2023
Attention: FQHC and RHC Providers
End date for vaccine procedure codes: May 12, 2023
Call to action: Texas Children’s Health Plan (TCHP) would like to remind FQHC and RHC providers of the guidance from Texas Medicaid and Healthcare Partnership (TMHP) on COVID-19 vaccine procedure codes. Effective for dates of service on or after May 12, 2023, claims submitted by federally qualified health centers (FQHCs) and rural health clinics (RHCs) for the administration of COVID-19 vaccines will no longer be reimbursed. The Texas Health and Human Services Commission (HHSC) has directed the Texas Medicaid & Healthcare Partnership (TMHP) to stop payments due to the end of the public health emergency (PHE).
How this impacts providers: Here is a complete list of the COVID-19 vaccine administration procedure codes that will not be reimbursed to FQHCs and RHCs for dates of service on or after May 12, 2023.
Procedure Codes
0001A
0002A
0003A
0004A
0011A
0012A
0013A
0031A
0034A
0041A
0042A
0044A
0051A
0052A
0053A
0054A
0064A
0071A
0072A
0073A
0074A
0081A
0082A
0083A
0091A
0092A
0093A
0094A
0111A
0112A
0113A
0124A
0134A
0144A
0154A
0164A
0173A
0174A
D1701
D1702
D1703
D1704
D1707
D1708
D1709
D1710
D1711
D1712
D1713
D1714
Please note the following:
Claims with the procedure codes listed in this table that were submitted by FQHCs and RHCs from May 12, 2023, through May 30, 2023, may be reprocessed.
Affected claims may result in recoupment, which will be reflected on future Remittance and Status Reports.
Previously, these codes were reimbursed at the fee schedule rate when billed on a different DOS from an encounter.
Next step for Providers: Providers should share this communication with their billing staff.