← Back to list
BT2022101: IHCP adds coverage for COVID-19 booster vaccines and administration
Act
immediately
Effective date
Aug 31, 2022
Identified
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers new Pfizer and Moderna bivalent COVID-19 booster vaccines and administration with four new CPT codes. Coverage is retroactive to August 31, 2022, with no prior authorization required and no copay for members.
Get alerts when payers change rules like this one
We check Indiana Medicaid (IHCP) and other payers every day and email you when a change matches your specialty and state.
Get Indiana Medicaid (IHCP) alertsPolicy Monitoring is free. No card required.
What to do
immediately · 3 steps
01Billing team must add new COVID-19 booster codes to system - CPT 91312 and 0124A for Pfizer (age 12+), CPT 91313 and 0134A for Moderna (age 18+).
02Submit all IHCP COVID-19 vaccination claims to Gainwell Technologies for professional claims and OptumRx for pharmacy claims, not managed care plans.
03Update encounter forms to include age restrictions and modifier U7 requirement for FSW/CIH Waiver providers.
Codes mentioned
9131291313
Original notice
BT2022101: IHCP adds coverage for COVID-19 booster vaccines and administration
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2023179: Coverage removed for Pfizer and Moderna COVID-19 vaccination codes; replacement codes providedMediumEffective Nov 1, 2023 · Medical PolicyBT202398: IHCP expands coverage for Moderna COVID-19 booster vaccine and administration codesMediumEffective Oct 12, 2022 · Medical PolicyBT2023117: Claims to be reprocessed after age coverage expansion for Moderna COVID-19 codesMediumEffective Oct 18, 2023 · Medical PolicyBT2020129: IHCP receives COVID-19 vaccine HCPCS update from CMS and AMAMediumEffective Dec 11, 2020 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list