MedicaidCoverageMedium impact
BT2023158: IHCP adds coverage for RSV vaccine Arexvy
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
May 3, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) now covers the RSV vaccine Arexvy (CPT 90679) for members age 60 and older with a maximum reimbursement of $294.00. No prior authorization or NDC is required, and claims will be automatically reprocessed starting December 20, 2023.
Action Required
Immediately: Billing team should verify system can bill CPT 90679 for RSV vaccine Arexvy for patients age 60+ on Indiana Medicaid. Update fee schedules to reflect $294.00 maximum reimbursement. Monitor remittance advices starting December 20, 2023 for automatic claim adjustments with ICNs beginning with 80 or 52. No prior authorization setup needed.