Texas MedicaidMedium ImpactCoverage
COVID-19 Vaccine Procedure Code 91323 a Benefit for Texas Medicaid and HTW Effective January 1, 2026
Published January 24, 2026Effective January 1, 2026
AI Summary
Effective January 1, 2026, Texas Medicaid and Healthy Texas Women (HTW) will cover COVID-19 vaccine procedure code 91323 and administration code 90480 for clients 12 years and older. TMHP will automatically reprocess affected claims for additional reimbursement.
Action Required
By January 1, 2026: Billing team must update system to begin billing procedure code 91323 for COVID-19 vaccines and code 90480 for administration for Texas Medicaid and HTW patients 12 years and older. Verify provider type and place of service eligibility in billing system. Monitor future R&S Reports for automatic reprocessing payments from TMHP.
Affected Billing Codes
9132390480
Plan Types
Medicaid
States
TX
Specialties
family-medicine, internal-medicine, pediatrics, ob-gyn, general-practice