MedicaidBilling CodesMedium impact
BT202308: Coverage added for COVID-19 bivalent vaccines and administration for children as young as 6 months
Indiana Medicaid (IHCP)·IN · Pediatrics, Family Medicine, General Practice·Medical Policy
Effective date
Dec 8, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) now covers COVID-19 bivalent vaccines and administration for children as young as 6 months, adding new billing codes for Moderna (ages 6 months-5 years) and Pfizer (ages 6 months-4 years) vaccines. The vaccine itself is provided at no charge, but administration fees are reimbursed at $36.90-$37.21.
Action Required
Immediately: Billing team must add new COVID-19 bivalent vaccine codes to billing system for Indiana Medicaid patients. Use codes 91316/0164A for Moderna (ages 6 months-5 years) and 91317/0173A for Pfizer (ages 6 months-4 years). Submit professional claims to Gainwell Technologies and pharmacy claims to OptumRx. Update encounter forms to include age-specific vaccine options for pediatric patients.