January 15, 2021

On Dec. 28, 2020, HHSC began offering the COVID-19 vaccine as a pharmacy benefit in Medicaid (fee-for-service and managed care) and CHIP. HHSC created a quick reference guide (PDF) to assist pharmacies with the correct process for submitting fee-for-service COVID-19 vaccine pharmacy claims. We encourage you to download and make this resource available to staff.

Contact the HHSC Pharmacy Benefit Access Help Desk at 1-800-435-4165 with questions about fee-for-service pharmacy claims submission.

Refer to the Pharmacy MCO Assistance Chart (PDF) for pharmacy call center phone numbers for each MCO if you have questions about submitting managed care claims.

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Drug