Date: October 4, 2024
Attention: All Providers
Effective date: October 1, 2024
Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after October 1, 2024, respiratory syncytial virus (RSV) vaccine procedure code 90683 will become a benefit of Texas Medicaid for individuals who are 60 years of age or older.
With ongoing cases of highly contagious respiratory illnesses, it is important to remind patients to protect themselves and their families by getting routine vaccinations. This can help prevent unnecessary medical visits and hospitalizations that continue to put a strain in our healthcare systems.
How this impacts providers: Procedure code 90683 may be reimbursed for the following provider types and places of service:
| Place of Service | Provider Type |
| Office | Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Pharmacist, Certified Nurse Midwife, Registered Nurse, Licensed Midwife, Comprehensive Care Program (CCP), Pharmacy |
| Home | Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, CCP |
| Outpatient Hospital | Hospital Providers |
| Other Locations | Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, CCP |
Administration for procedure code 90683 may be reimbursed when billed with corresponding vaccine administration procedure code 90471 or 90472.
Next step for Providers: Providers are encouraged to share this communication 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.