MedicaidBilling CodesMedium impact
BT202224: Pharmacy claim processing clarified for administration of third and booster doses of COVID-19 vaccine
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics·Pharmacy
Effective date
Apr 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) clarifies pharmacy billing codes for COVID-19 vaccine third and booster doses, including specific NCPDP codes and administration fees for immunocompromised patients. All COVID-19 vaccine claims must be submitted to OptumRx FFS system regardless of managed care enrollment.
Action Required
By April 1, 2022: Pharmacy billing team must update point-of-sale (POS) systems with new NCPDP codes for COVID-19 vaccine administration - use Service Clarification Codes 7 or 10 for third/booster doses, set administration fee to $37.21, and submit all claims to OptumRx FFS system. Contact OptumRx Clinical Help Desk at 855-577-6317 for questions.