MedicaidBilling CodesMedium impact
BT202431: IHCP adds coverage for Beyfortus RSV vaccine administration for babies
Indiana Medicaid (IHCP)·IN · Pediatrics, Family Medicine·Medical Policy
Effective date
Oct 6, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers administration of Beyfortus RSV vaccine for babies birth to 24 months old using new specific CPT codes 96380 and 96381 effective October 6, 2023. The generic injection code 96372 should no longer be used for Beyfortus administration after October 5, 2023.
Action Required
Immediately: Billing team must stop using CPT 96372 for Beyfortus RSV vaccine administration and switch to CPT 96380 (with counseling) or 96381 (administration only) with SL modifier for VFC program billing. Update billing system to use these specific codes for members birth to 24 months old. Maximum reimbursement is $15 per administration.