MedicaidBilling CodesMedium impact
BT2023132: IHCP announces COVID-19 vaccine pharmacy benefit updates for 2023-2024 season
Indiana Medicaid (IHCP)·IN·Pharmacy
Effective date
Sep 11, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) will now reimburse pharmacies for updated 2023-2024 Moderna and Pfizer COVID-19 vaccines effective September 11, 2023, as these are no longer available free from government stock. Billing procedures change October 1, 2023 - pharmacies must stop using Service Clarification Code 420-DK and submit only Professional Service Code 440-E5 with MA for administration fees.
Action Required
By October 1, 2023: Billing team must update pharmacy billing procedures to stop using Service Clarification Code (420-DK) for COVID-19 vaccine claims. Continue using Professional Service Code (440-E5) with MA for administration fees only. VFC-enrolled pharmacies receive $15.00 administration fee, non-VFC enrolled receive $38.75. Claims submitted between Sept 11-Oct 5 with old codes can be reprocessed for reimbursement.