Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Update to Age Restrictions for Vaccine Procedure Codes 90671 (Vaxneuvance) and 90756 (Flucelvax Quadrivalent)
Date: January 23, 2023
Attention: Providers
Effective date: February 1, 2023 for dates of service on or after December 1, 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: The Food and Drug Administration has expanded the age limitations for the following vaccines:
Vaxneuvance™ (pneumococcal 15-valent conjugate vaccine), procedure code 90671, to be used in individuals 6 weeks of age or older
Flucelvax® Quadrivalent (influenza vaccine), procedure code 90756, to be used in individuals 6 months of age or older
The age limitations for vaccine procedure codes will be expanded to reflect the FDA changes above. This change is effective for any procedures provided on or after December 1, 2022.
How this impacts providers:
Managed care organizations will reprocess affected claims submitted with these codes and date of service on or after December 1, 2022. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.
Next steps for providers: Prescribers should adjust their prescribing patterns accordingly and share this update with their staff as well.
