Provider Alert! Date: Pneumococcal Vaccine Procedure Codes 90671 and 90677 Become Benefits of Texas Medicaid
Date: January 13, 2022
Attention: Primary Care Providers
Effective Date: March 1, 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: The U.S. Food and Drug Administration (FDA) approved the use of PREVNAR 20 (procedure code 90677) on June 10, 2021 and the use of VAXNEUVANCE – PREVNAR 15 (procedure code 90671) on July 16, 2021.
How this impacts providers: Effective for dates of service on or after March 1, 2022, pneumococcal vaccine procedure codes 90671 and 90677 will become benefits of Texas Medicaid for Members who are 18 years of age or older as follows:
Place of Service | When Services are Provided by |
Office | Physician assistant (PA), nurse practitioner (NP), clinical nurse specialist (CNS), physician, pharmacy, pharmacist, certified nurse midwife, registered nurse, federally qualified health center (FQHC), Texas Health Steps (THSteps) medical, and Comprehensive Care Program (CCP) providers |
Home | PA, NP, CNS, physician, FQHC, THSteps medical, and CCP providers |
Outpatient hospital | FQHC, hospital, and THSteps medical providers |
Other location | PA, NP, CNS, physician, FQHC, THSteps medical, and CCP providers |
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
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