← Back to list
BT202224: Pharmacy claim processing clarified for administration of third and booster doses of COVID-19 vaccine
Act
by Apr 1, 2022
Effective date
Apr 1, 2022
Identified
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.
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
by Apr 1, 2022 · 2 steps
01Pharmacy 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.
02Contact OptumRx Clinical Help Desk at 855-577-6317 for questions.
Original notice
BT202224: Pharmacy claim processing clarified for administration of third and booster doses of COVID-19 vaccine
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2020127: IHCP to reimburse pharmacy providers for COVID-19 vaccine administrationMediumEffective Dec 15, 2020 · PharmacyBT2021100: IHCP to cover Covid-19 vaccine booster shotsHighEffective Oct 20, 2021 · Provider BulletinBT2023132: IHCP announces COVID-19 vaccine pharmacy benefit updates for 2023-2024 seasonMediumEffective Sep 11, 2023 · PharmacyBrowse every Indiana Medicaid (IHCP) change in the policy list