Provider Alert! Reimbursement Rate Updates for COVID-19 Pfizer Vaccine Administration Procedure Codes 0071A and 0072A

Date: November 22, 2021

Attention: All Providers, including pharmacists

Effective Date: Dates of service on or after October 29, 2021

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: For dates of service on or after October 29, 2021, the reimbursement rates for COVID-19 Pfizer vaccine administration procedure codes 0071A (first dose) and 0072A (second dose) will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. How this impacts providers: This applies to patients five years old and older. Dose information is as follows:

• First dose—0071A- Pfizer Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation
• Second dose— 0072A-Pfizer Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation

Next steps for providers: Providers should share this communication with their staff.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers