← Back to list
BT202289: IHCP to expand age ranges for Novavax COVID-19 vaccine and administration procedure codes
Act
immediately
Effective date
Aug 19, 2022
Identified
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.
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 update system settings to allow billing of codes 91304, 0041A, and 0042A for Indiana Medicaid members ages 12-17.
02Submit all claims to Gainwell Technologies (professional) or OptumRx (pharmacy).
03Update age verification procedures to confirm eligibility for members 12 and older.
Codes mentioned
91304
Original notice
BT202289: IHCP to expand age ranges for Novavax COVID-19 vaccine and administration procedure codes
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2026182: COVID-19 vaccine administration to no longer be carved out of managed careHighEffective Jan 1, 2027 · Provider BulletinBT202156: Coverage and billing information for the July 2021 HCPCS code updateMediumEffective Jul 1, 2021 · Claims & BillingBT202267: IHCP to cover Novavax COVID-19 vaccine and administrationMediumEffective Jul 13, 2022 · Provider BulletinBT2022105: IHCP adds coverage for Novavax COVID-19 booster vaccineMediumEffective Oct 19, 2022 · Medical PolicyBrowse every Indiana Medicaid (IHCP) change in the policy list