MedicaidReimbursementMedium impact
BT202279: IHCP announces pharmacy reimbursement for COVID-19 bivalent booster administration
Indiana Medicaid (IHCP)·IN·Pharmacy
Effective date
Sep 2, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) will now reimburse pharmacies for administering COVID-19 bivalent booster vaccines (Moderna for ages 18+ and Pfizer-BioNTech for ages 12+) effective September 2, 2022. Pharmacies must use specific NCPDP codes for point-of-sale billing with a $37.21 administration fee.
Action Required
Effective September 2, 2022: Pharmacies must update billing systems to use NCPDP point-of-sale codes for COVID-19 bivalent booster administration claims. Use professional service code MA with service clarification code 7 or 10, administration fee $37.21, basis of cost 15, and ingredient cost $0.00 or $0.01. Ensure age restrictions are followed (Moderna 18+, Pfizer 12+) to avoid NCPDP reject code 76.