MedicaidCoverageMedium impact
COVID-19 Bivalent Booster Vaccination Age Range Lowered
Illinois Medicaid - HFS·IL · Family Medicine, Pediatrics, Internal Medicine +1 more·Provider Notice
Effective date
Oct 12, 2022
We identified it
Jun 20, 2026
Summary
The minimum age for COVID-19 bivalent booster vaccinations has been lowered: Pfizer-BioNTech boosters are now available starting at age 5 (down from 12) and Moderna boosters at age 6 (down from 18). This change affects Medicaid fee-for-service and HealthChoice Illinois managed care plans.
Action Required
Immediately: Billing team must update patient eligibility verification systems to reflect new minimum ages for COVID-19 bivalent boosters - Pfizer-BioNTech at age 5+ and Moderna at age 6+. Update encounter forms and EMR templates to reflect expanded age ranges. Review HFS COVID-19 Fee Schedule for any billing updates.