MedicaidCoverageMedium impact
BT202289: IHCP to expand age ranges for Novavax COVID-19 vaccine and administration procedure codes
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Aug 19, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) has expanded coverage of Novavax COVID-19 vaccine and administration codes to include children ages 12-17, lowering the minimum age from 18. Three specific codes (91304, 0041A, 0042A) are now covered for members ages 12 and older, effective retroactively to August 19, 2022.
Action Required
Immediately: Billing team must update system settings to allow billing of codes 91304, 0041A, and 0042A for Indiana Medicaid members ages 12-17. Submit all claims to Gainwell Technologies (professional) or OptumRx (pharmacy). Update age verification procedures to confirm eligibility for members 12 and older.