MedicaidCoverageMedium impact
COVID-19 Vaccine Procedure Code 91323 a Benefit for Texas Medicaid and HTW Effective January 1, 2026
Texas Medicaid·TX · Family Medicine, Internal Medicine, Pediatrics +2 more·Coding
Effective date
Jan 1, 2026
We identified it
Jan 24, 2026
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.