MedicaidCoverageMedium impact
Adult Vaccines Added to the Medicaid Formulary on June 1, 2026
Texas Medicaid·TX · Family Medicine, Internal Medicine, General Practice·Pharmacy
Effective date
Jun 1, 2026
We identified it
Jun 13, 2026
Summary
Effective June 1, 2026, Texas Medicaid now covers all recommended adult vaccines (ages 19+) as pharmacy benefits, allowing reimbursement for both vaccine ingredients and administration costs. Pharmacies must have a Collaborative Practice Agreement or patient-specific prescription to administer vaccines under this benefit.
Action Required
Immediately: Billing team should verify with local pharmacies whether they have Collaborative Practice Agreements for vaccine administration. Update vaccine billing workflows to account for potential pharmacy benefit coverage as an alternative to medical benefit billing for Medicaid patients ages 19+. Contact vdp-formulary@hhs.texas.gov for specific vaccine list and coverage details.