Provider Alert! Updates to Vaccine Administration Procedure Code M0201

Provider Alert!

Provider Alert! Updates to Vaccine Administration Procedure Code M0201

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:

90630906369065490655906569065790658
90660906619066290670906719067290673
90674906779068290685906869068790688
90694906979072390732907399074090743
9074490746907479075690759  

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.

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