MedicaidBilling CodesMedium impact
BT2023162: IHCP announces pharmacy benefit updates to COVID-19 vaccine reimbursement
Indiana Medicaid (IHCP)·IN·Pharmacy
Effective date
Oct 3, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) will now reimburse pharmacies for the updated 2023-2024 Novavax COVID-19 vaccine effective October 3, 2023, and will allow non-VFC enrolled pharmacies to receive reimbursement for VFC-eligible members starting November 14, 2023. Pharmacies should no longer use Service Clarification Code 420-DK for COVID-19 vaccine claims and must use Professional Service Code 440-E5 with MA designation for administration fees.
Action Required
Immediately: Pharmacies must stop using Service Clarification Code (420-DK) for COVID-19 vaccine reimbursement claims. Use Professional Service Code (440-E5) with MA designation for administration fees. For claims with dates of service October 3, 2023 or later that used the old codes, reprocess claims to receive ingredient cost reimbursement. Update billing system to reflect these code changes for all Indiana Medicaid COVID-19 vaccine claims.