Effective 10/01/24: RSV Vaccine Procedure Code 90683 Becomes a Benefit of Texas Medicaid

Date: 10/07/24

Effective for dates of service on or after October 1, 2024, Respiratory Syncytial Virus (RSV) vaccine procedure code 90683 will become a benefit of Texas Medicaid (STAR, STAR Health, STAR+PLUS) for individuals who are 60 years of age or older.

Procedure code 90683 may be reimbursed for the following provider types and places of service:

Place of Service	Provider Type
Office	Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Pharmacist, Certified Nurse Midwife, Registered Nurse, Licensed Midwife, Comprehensive Care Program (CCP), Pharmacy
Home	Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, CCP
Outpatient Hospital	Hospital Providers
Other Locations	Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, CCP

Administration for procedure code 90683 may be reimbursed when billed with corresponding vaccine administration procedure code 90471 or 90472.

For more information, please review the Texas Medicaid Provider Procedures Manual.

For questions, please contact your local Account Manager. To access their contact information visit Find My Account Manager.