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:

90630	90636	90654	90655	90656	90657	90658
90660	90661	90662	90670	90671	90672	90673
90674	90677	90682	90685	90686	90687	90688
90694	90697	90723	90732	90739	90740	90743
90744	90746	90747	90756	90759

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.