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BT202334: Third-dose administration of Moderna COVID-19 vaccine covered for ages 6 months through 5 years
Act
by Jul 24, 2023
Effective date
Jun 17, 2022
Identified
Jun 19, 2026
Summary
Indiana Medicaid will now reimburse for third-dose Moderna COVID-19 vaccine administration (CPT 0113A) for immunocompromised children ages 6 months through 5 years, retroactive to June 17, 2022. The reimbursement rate is $37.21 for dates of service through December 31, 2022, and $38.95 for dates of service on or after January 1, 2023.
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What to do
by Jul 24, 2023 · 4 steps
01Billing team must update system to include new CPT code 0113A for third-dose Moderna COVID-19 vaccine administration for ages 6 months through 5 years.
02Link to vaccine code 91311 and revenue code 636.
03Set reimbursement rates: $37.21 for DOS through 12/31/22, $38.95 for DOS after 1/1/23.
04Resubmit eligible claims within 90 days for managed care or 180 days for fee-for-service, including copy of bulletin first page.
Codes mentioned
91311
Original notice
BT202334: Third-dose administration of Moderna COVID-19 vaccine covered for ages 6 months through 5 years
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT202251: Coverage and billing information for the July 2022 quarterly HCPCS codes updateMediumEffective Jul 1, 2022 · Claims & BillingBT202262: IHCP to cover COVID-19 vaccine for children as young as age 6 monthsMediumEffective Jun 17, 2022 · Provider BulletinBT202361: IHCP removes coverage for Pfizer and Moderna monovalent COVID-19 vaccine codesMediumEffective Apr 18, 2023 · Medical PolicyBrowse every Indiana Medicaid (IHCP) change in the policy list