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BT202218: IHCP to cover additional COVID-19 vaccine and administration codes
Act
immediately
Effective date
Jan 3, 2022
Identified
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers additional COVID-19 vaccine and administration codes for Pfizer's ready-to-use vaccine, including third-dose and booster administration codes. The vaccine itself is reimbursed at $0 but administration codes pay up to $36.40 per dose for dates of service after 1/1/2022.
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What to do
immediately · 5 steps
01Billing team must update system to include new COVID-19 vaccine codes 91305, 0051A, 0052A, 0053A, 0054A, and 0073A.
02Link all codes to revenue code 636.
03Configure system to bill vaccine at $0 and administration at $36.40 for DOS after 1/1/2022.
04Submit professional claims to Gainwell Technologies (FFS vendor) and pharmacy claims to OptumRx, not to managed care plans.
05Ensure no copays are charged to IHCP members.
Codes mentioned
91305
Original notice
BT202218: IHCP to cover additional COVID-19 vaccine and administration codes
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT202361: IHCP removes coverage for Pfizer and Moderna monovalent COVID-19 vaccine codesMediumEffective Apr 18, 2023 · Medical PolicyBT2020127: IHCP to reimburse pharmacy providers for COVID-19 vaccine administrationMediumEffective Dec 15, 2020 · PharmacyBT2020129: IHCP receives COVID-19 vaccine HCPCS update from CMS and AMAMediumEffective Dec 11, 2020 · Claims & BillingBT202126: Additional codes covered for COVID-19 vaccine and treatmentMediumEffective Feb 9, 2021 · Provider BulletinBrowse every Indiana Medicaid (IHCP) change in the policy list