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BT202102: IHCP update for COVID-19 vaccination pharmacy claims ordered and administered by pharmacists

Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Pharmacy
Effective date
Jan 14, 2021
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) now allows pharmacists to submit COVID-19 vaccination claims using the pharmacy's NPI as both the provider and prescriber, effective immediately. Pharmacists must use NCPDP Service Clarification Code 42 and follow specific prescription documentation requirements.

Action Required

Action needed
Immediately: If your practice works with pharmacists for COVID-19 vaccinations in Indiana, ensure they use the pharmacy's NPI as prescribing NPI and include NCPDP Service Clarification Code 42. Pharmacists must document prescribing information on prescription forms with their name, signature, and pharmacy NPI. Contact OptumRx Clinical Help Desk at 1-855-577-6317 for questions.