Provider Alert! Booster Dose Moderna COVID-19 Vaccine for Adults Added to the FormularyTexas Children's Health Plan
Date: May 31, 2022
Attention: All Providers
Effective Date: May 13, 2022
Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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: Texas Children’s Health Plan (TCHP) would like to inform providers that the U.S. Food and Drug Administration (FDA), under an emergency use authorization (EUA), authorized the Moderna COVID-19 vaccine to prevent COVID-19 in individuals 18 years and older. The manufacturer of the Moderna COVID-19 vaccine has developed a new booster dose-only formulation also authorized under the EUA for individuals 18 and older.
How this impacts providers: On May 13, 2022, HHSC added formulary coverage for the new booster dose-only formulation of the Moderna COVID-19 Vaccine. The following national drug codes (NDCs) were added to the formulary for Medicaid and CHIP as a reimbursable pharmacy benefit:
|Moderna COVID-19 Vaccine (EUA)||0.5 mL||80777-0275-05|
|Moderna COVID-19 Vaccine (EUA)||0.5 mL||80777-0275-99|
HHSC continues to cover the vaccine administration based on the Medicare rate for vaccine administration as non-risk. As a reminder, there is currently no ingredient cost associated with the vaccine.
Next steps for providers: Prescribers should share this communication with their staff.
If you have any questions, please email Provider Network Management at: firstname.lastname@example.org.