MedicaidReimbursementMedium impact
BT202547: IHCP revises reimbursement criteria for monkeypox vaccine (90611)
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics +1 more·Claims & Billing
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) now reimburses the monkeypox vaccine (CPT 90611) at $283.50 with no prior authorization or NDC requirements. This change is retroactive to April 1, 2024, and providers can resubmit previously denied claims within specified timeframes.
Action Required
Immediately: Billing team should resubmit any previously denied claims for CPT 90611 within 90 days for managed care or 180 days for fee-for-service claims. Include copy of bulletin first page with resubmissions. Update billing system to remove prior authorization requirements for CPT 90611 for Indiana Medicaid patients. Verify reimbursement rate is set to $283.50 maximum fee.