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BT202172: IHCP to reimburse administration for third dose of specified COVID-19 vaccines
Act
immediately
Effective date
Aug 12, 2021
Identified
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP/Medicaid) will now reimburse providers for administering third doses of Pfizer and Moderna COVID-19 vaccines to immunocompromised individuals. New CPT codes 0003A and 0013A are covered with $37.21 reimbursement, effective immediately for services on or after August 12, 2021.
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What to do
immediately · 3 steps
01Billing team must update system to include new COVID-19 third dose administration codes 0003A (Pfizer) and 0013A (Moderna) with $37.21 reimbursement rate for IHCP members.
02Submit claims to Gainwell Technologies for medical benefit claims or OptumRx for pharmacy claims.
03Ensure no copay is charged to members and bill Medicare first for dual-eligible patients.
Original notice
BT202172: IHCP to reimburse administration for third dose of specified COVID-19 vaccines
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2021100: IHCP to cover Covid-19 vaccine booster shotsHighEffective Oct 20, 2021 · Provider BulletinBT202218: IHCP to cover additional COVID-19 vaccine and administration codesMediumEffective Jan 3, 2022 · Provider BulletinBT2022101: IHCP adds coverage for COVID-19 booster vaccines and administrationMediumEffective Aug 31, 2022 · Medical PolicyBrowse every Indiana Medicaid (IHCP) change in the policy list