COVID-19 Vaccine Administration Code M0201 Benefit – Texas Medicaid
What is new?
Effective for dates of service on or before, June 8, 2021, Texas Medicaid and Healthcare Partnership (TMHP) 
, advises you to file using the procedure code M0201- when billing as a COVID-19 vaccine administrator in a Medicaid member home setting
Provider must resubmit claims for add-on procedure code M0201 for a home setting on or after June 8 ,2021. We will reprocess affected claims submitted with the procedure code and date of service on or after June 8, 2021. Providers are not required to appeal the claims unless they are denied for another reason after the claims reprocessing is complete.
The Vaccine Administration code M0201 is defined as - COVID-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home and must be filed with one of the following:
| Vaccine Code | Use | Description |
| 0001A | Admin | Pfizer-Biontech Covid-19 Vaccine Administration – First Dose ADM SARSCOV2 30MCG/0.3ML 1ST |
| 0002A | Admin | Pfizer-Biontech Covid-19 Vaccine Administration – Second Dose ADM SARSCOV2 30MCG/0.3ML 2ND |
| 0003A | Admin | Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage; third dose |
| 0011A | Admin | Moderna Covid-19 Vaccine Administration – First Dose ADM SARSCOV2 100MCG/0.5ML1ST |
| 0012A | Admin | Moderna Covid-19 Vaccine Administration – Second Dose ADM SARSCOV2 100MCG/0.5ML2ND |
| 0013A | Admin | Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage; third dose |
| 0031A | Admin | Janssen/Johnson & Johnson - Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5mL dosage, single dose |
Medicaid Benefit for the following provider types:
Home: Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Clinic/Group Practice, Home Health Agency and Comprehensive Care Partnership Provider.
Resources
Providers interested in enrolling as a COVID-19 vaccinator.
Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration and Cost Sharing under Medicaid, the Children’s Health Insurance Program, and Basic Health Program - CMS Medicaid Toolkit
Questions
For questions or additional information, please contact our:
- BCBSTX Medicaid Provider Service Center at 1-877-560-8055
- Your BCBSTX Medicaid Provider Network Representative at 1-855-212-1615
- Submit via email Texas Medicaid Network Department
