MedicaidCoverageMedium impact
BT202529: IHCP adds coverage for adjuvanted flu vaccine Fluad (90653)
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Aug 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers the adjuvanted flu vaccine Fluad (CPT 90653) for members age 65 and older under the medical benefit, effective retroactively to August 1, 2024. No prior authorization or NDC required, with a maximum fee of $76.24.
Action Required
Immediately: Billing team should verify CPT 90653 is active in billing system for IHCP members age 65+ with maximum fee of $76.24. No prior authorization setup needed. For retroactive claims between Aug 1, 2024 and March 4, 2025: Submit within 90 days (managed care) or 180 days (FFS) of March 4, 2025, and include first page of bulletin BT202529 when submitting claims beyond standard filing limits. Monitor remittance advices starting March 27, 2025 for mass reprocessed claims with ICNs beginning with 52 or 80.