Vaxelis to Become Available for Texas Medicaid

June 30, 2021


What is New?

Beginning July 1, 2021, procedure code 90697 for Vaxelis, a three-dose vaccine series, will become available to Texas Medicaid members through the Texas Vaccines for Children Program (TVFC) Learn more about third-party links. Only children from six weeks through four years of age (prior to their fifth birthday) may receive the vaccine.

Vaccine Administration claims submission information:

Vaccine Code




Vaccine (Information Only)

Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus b Conjugate and Hepatitis B Vaccine



Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional



Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections)

Is there a cost?

Vaxelis is available and free of charge to providers through TVFC.

Requirements for Billing:

  • Ages: Six weeks through four years old (prior to their fifth birthday).
  • What’s reimbursed: TVFC is currently supplying Vaxelis to providers free of charge. We won't reimburse for Vaxelis that providers receive for free. Providers should not charge members for the treatment. We will reimburse for the administration of the treatment.

Have questions:

Contact our BCBSTX Medicaid Provider Service Center at 1-877-560-8055 or contact your BCBSTX Medicaid Provider Network Representative at 1-855-212-1615.

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.

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