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Indiana Medicaid (IHCP)Medicaid · Coverage · Provider Bulletin · IN · Family Medicine, Pediatrics, General PracticeMedium impact

BT202262: IHCP to cover COVID-19 vaccine for children as young as age 6 months

Act
immediately
Effective date
Jun 17, 2022
Identified
Jun 19, 2026

Summary

Indiana Health Coverage Programs (IHCP) will now cover and reimburse COVID-19 vaccines for children as young as 6 months old, effective June 17, 2022. New CPT codes have been established for both Moderna (ages 6 months-5 years) and Pfizer (ages 6 months-4 years) vaccines and their administration, with vaccines provided at no charge and administration reimbursed at $36.90 per dose.

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What to do

immediately · 5 steps
01Billing team must update system to include new COVID-19 vaccine codes for children 6 months-5 years.
02Configure codes 91308, 91311, 0081A-0083A, 0111A-0112A with $36.90 administration fee and $0 vaccine cost.
03Set age restrictions: Pfizer codes (91308, 0081A-0083A) for ages 6 months-4 years, Moderna codes (91311, 0111A-0112A) for ages 6 months-5 years.
04Link all codes to revenue code 636.
05Submit claims to Gainwell Technologies for medical benefit and OptumRx for pharmacy claims.

Codes mentioned

913089131091311

Original notice

BT202262: IHCP to cover COVID-19 vaccine for children as young as age 6 months
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202251: Coverage and billing information for the July 2022 quarterly HCPCS codes updateMediumEffective Jul 1, 2022 · Claims & BillingBT202361: IHCP removes coverage for Pfizer and Moderna monovalent COVID-19 vaccine codesMediumEffective Apr 18, 2023 · Medical PolicyBT202334: Third-dose administration of Moderna COVID-19 vaccine covered for ages 6 months through 5 yearsMediumEffective Jun 17, 2022 · Provider BulletinBT2020129: 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

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesFamily MedicinePediatricsGeneral PracticeCode 91308Code 91310Code 91311

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