Immunization Benefits to Change for Texas Medicaid ... - TMHP.com
Immunization Benefits to Change for Texas Medicaid ... - TMHP.com
Immunization Benefits to Change for Texas Medicaid ... - TMHP.com
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<strong>Immunization</strong> <strong>Benefits</strong> <strong>to</strong> <strong>Change</strong> <strong>for</strong> <strong>Texas</strong> <strong>Medicaid</strong>April 1, 2013In<strong>for</strong>mation posted February 15, 2013Effective <strong>for</strong> dates of service on or after April 1, 2013, immunization benefits will change<strong>for</strong> <strong>Texas</strong> <strong>Medicaid</strong>.Routine immunizations (vaccines and <strong>to</strong>xoids) re<strong>com</strong>mended by the Advisory Committeeon <strong>Immunization</strong> Practices (ACIP) are a benefit of <strong>Texas</strong> <strong>Medicaid</strong>.Providers must follow current ACIP general usage re<strong>com</strong>mendations unless they conflictwith guidelines from the <strong>Texas</strong> Vaccines <strong>for</strong> Children (TVFC) Program, in which caseproviders must follow TVFC guidelines.Vaccines will no longer be defined by the number of state-defined <strong>com</strong>ponents.Benefit <strong>Change</strong>sProcedure code 90662 will be a new benefit of <strong>Texas</strong> <strong>Medicaid</strong>.Procedure codes 90645, 90646, 90704, 90705, and 90706 will no longer be a benefit of<strong>Texas</strong> <strong>Medicaid</strong>.The following table has been updated with vaccines that are distributed through <strong>Texas</strong>Vaccines <strong>for</strong> Children:Procedure Codes90632 90633* 90636 90647* 90648* 90649* 90650*90654 90655* 90656* 90657* 90658* 90660* 9066290669 90670* 90672* 90680* 90681* 90696* 90698*90700* 90702* 90703 90707* 90710* 90713* 90714*90715* 90716* 90721 90723* 90732* 90733 90734*90736 90743 90744* 90746 90748* 90749* Indicates a vaccine/<strong>to</strong>xoid that is distributed through TVFCAll vaccines listed above may be reimbursed <strong>to</strong> the following provider types:Place of Service (POS) 1 POS 2 POS 5 POS 9Physician, nurse practitioner (NP),clinical nurse specialist (CNS),physician assistant (PA),pharmacist, and pharmacyPhysician, NP,CNS, PAHospitals Physician, NP,CNS, PAProcedure Codes 90740 and 90747Procedure codes 90740 and 90747 are not considered routine vaccines and may bebilled using administration code 96372 or 96374. These procedure codes are no longerreimbursed <strong>to</strong> <strong>Texas</strong> Health Steps (THSteps) providers.Procedure codes 90740 and 90747 may be reimbursed <strong>to</strong> the following provider types:
Place of Service (POS) 1 POS 2 POS 5 POS 9Physician, nurse practitioner (NP),clinical nurse specialist (CNS),physician assistant (PA),nephrology, pharmacist, andpharmacyPhysician, NP,CNS, PAHospitals,nephrology,renal dialysisfacilityFor more in<strong>for</strong>mation, call the <strong>TMHP</strong> Contact Center at 1-800-925-9126.Physician, NP,CNS, PA
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