Date: February 26, 2024
Attention: All Providers
Effective: January 1, 2024
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective January 1, 2024, vaccine administration add-on procedure code M0201 may be billed in the home setting with the following procedure codes:
| 90630 | 90636 | 90654 | 90655 | 90656 | 90657 | 90658 |
| 90660 | 90661 | 90662 | 90670 | 90671 | 90672 | 90673 |
| 90674 | 90677 | 90682 | 90685 | 90686 | 90687 | 90688 |
| 90694 | 90697 | 90723 | 90732 | 90739 | 90740 | 90743 |
| 90744 | 90746 | 90747 | 90756 | 90759 |
M0201 will be payable as an add-on code if billed with any of these vaccines, along with the existing COVID-19 vaccine administration procedure code, if administered inside a client’s home.
TCHP will reprocess affected claims submitted with the M0201 procedure code and date of service on or after January 1, 2024. Providers are not required to appeal the claims unless they are denied for other reasons after the claims reprocessing is complete. Providers may bill TCHP retroactively for procedure code M0201.
Next step for providers: Providers should share this information with their 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.