MedicaidBilling CodesMedium impact
BT202218: IHCP to cover additional COVID-19 vaccine and administration codes
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
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.
Action Required
Immediately: Billing team must update system to include new COVID-19 vaccine codes 91305, 0051A, 0052A, 0053A, 0054A, and 0073A. Link all codes to revenue code 636. Configure system to bill vaccine at $0 and administration at $36.40 for DOS after 1/1/2022. Submit professional claims to Gainwell Technologies (FFS vendor) and pharmacy claims to OptumRx, not to managed care plans. Ensure no copays are charged to IHCP members.