Provider Alert! COVID-19 Vaccine Administration Procedure Codes 0124A & 0134A Are Now Benefits for Medicaid & CHIP

Date: October 12, 2022

Attention: All Providers

Effective Date: August 31, 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: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after August 31, 2022, in accordance with the U.S. Food and Drug Administration’s (FDA) Emergency Use Authorization (EUA), COVID-19 vaccine administration codes 0124A and 0134A are benefits of Medicaid and CHIP for the administration of the following:

• Pfizer COVID-19 Omicron-specific booster vaccine to individuals 12 years of age and older
• Moderna COVID-19 Omicron-specific booster vaccine to individuals 18 years of age and older.

Vaccine procedure codes 91312 and 91313 are informational only while the vaccines are distributed to providers free of charge.

Procedure codes 0124A and 0134A are benefits of Medicaid and CHIP for the following providers and places of service:

How this impacts providers: As of August 31, 2022, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure code 0124A or 0134A.

Providers interested in enrolling as a COVID-19 vaccinator should visit www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx for more information.

Next steps for providers: Providers are encouraged to 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