MedicaidCoverageMedium impact
BT2025176: IHCP adds coverage of meningococcal pentavalent vaccine Penmenvy (90624)
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics·Medical Policy
Effective date
Apr 1, 2025
We identified it
Jun 18, 2026
Summary
IHCP (Indiana Medicaid) now covers the Penmenvy meningococcal pentavalent vaccine (CPT 90624) for members age 10-23, effective retroactively to April 1, 2025. The vaccine reimburses at $262.50 for ages 19-23 but $0 for ages 10-18 due to VFC program availability.
Action Required
By January 31, 2026: Billing team must update system to bill CPT 90624 for Penmenvy vaccine for Indiana Medicaid members age 10-23. Use revenue code 636 for institutional claims. Add SL modifier for VFC-eligible members age 10-18. Submit retroactive claims within 90 days (managed care) or 180 days (FFS) with bulletin attachment if beyond standard filing limits.