Order and Administration of Selected COVID-19 Monoclonal Antibody Therapeutics Reimbursable Through Medicaid Medical Claims System

Published on
November 1, 2021

The US Department of Health and Human Services (HHS) amended the COVID-19 Public Readiness and Emergency Preparedness (PREP) Act to allow pharmacists to order and administer selected COVID-19 therapeutics, including subcutaneous monoclonal antibodies.

HHSC updated the fee-for-service medical claims system to allow for reimbursement to pharmacists and pharmacy providers with an effective service date on or after Sept. 9, 2021.

Pharmacies and pharmacists interested in administering selected COVID-19 therapeutics to people enrolled in Medicaid must complete an enrollment application at tmhp.com/topics/provider-enrollment.

For people enrolled in Medicaid managed care, pharmacies and pharmacists must enroll with the MCO in their service area. Contact the TMHP Contact Center at 800-925-9126 or email TMHP Provider Relations to request assistance from the local TMHP provider relations representative in your area.

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