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BT2020129: IHCP receives COVID-19 vaccine HCPCS update from CMS and AMA
Effective date
Dec 11, 2020
Identified
Jun 19, 2026
Summary
Indiana Medicaid reimburses COVID-19 vaccines and their administration under new HCPCS codes effective for dates of service on or after December 11, 2020. The vaccine codes are 91300 (Pfizer BioNTech) and 91301 (Moderna), and the administration codes are 0001A and 0002A for the first and second doses of the 30 mcg vaccine, plus 0011A and 0012A for the 100 mcg vaccine. COVID-19 vaccine reimbursement is carved out of managed care benefits, and the vaccines are supplied free of charge to all IHCP members, while the IHCP pays zero for the vaccine codes until further notice.
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What to do
Action · 15 steps
01Already effective December 11, 2020: Bill covered COVID-19 vaccine codes and their administration codes for dates of service on or after December 11, 2020.
02Codes 0001A and 0002A are effective 12/11/2020, and the effective date for 0011A, 0012A and 91301 is listed as TBD.
03Bill 91300 with 0001A (first dose) and 0002A (second dose), and note that the administration codes are allowed for ambulance providers (provider specialty 260).
04Max fees are $16.94 for 0001A and 0011A and $28.39 for 0002A and 0012A.
05Because the vaccine is available at no charge, the IHCP pays zero for 91300 and 91301 until further notice, but providers are still encouraged to bill the vaccine codes for data collection.
06To bill separately in an outpatient setting, bill 91300 and 91301 with revenue code 636 where appropriate.
07Managed care members: submit COVID-19 vaccination claims to the fee-for-service claim-processing vendor, Gainwell Technologies.
08Dually eligible members: bill COVID-19 vaccination claims to the member's Medicare plan provider.
09Limited benefit programs (Family Planning Eligibility Program, Presumptive Eligibility, and Emergency Services Only): bill only COVID-19 vaccines and vaccine administrations, and add ICD-10 code Z23 to the claim.
10For Family Planning Eligibility Program and Presumptive Eligibility professional claims, indicate Z23 at the detail level for the vaccine and administration.
11For outpatient claims for these programs, Z23 must be primary (principal) on the claim.
12For Emergency Services Only, enter Y in the EMG field on paper claims, or check the EMG box in the IHCP Provider Healthcare Portal, for each applicable detail.
13Providers administering two-dose vaccines should instruct members to use the same provider for both doses and to receive the second dose on the date specified by the manufacturer's product labeling.
14Providers should also remind members that IHCP covers transportation to medical services, and members (or providers on their behalf) can schedule transportation through the entity under which they are enrolled.
15The Moderna vaccine is not yet FDA approved, and an update will be issued upon approval.
Codes mentioned
9130091301Z23
Original notice
BT2020129: IHCP receives COVID-19 vaccine HCPCS update from CMS and AMA
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT202129: DDRS waiver providers to provide COVID-19 vaccines to eligible FSW and CIH waiver membersMediumEffective Apr 8, 2021 · Specialty ServicesBT202361: IHCP removes coverage for Pfizer and Moderna monovalent COVID-19 vaccine codesMediumEffective Apr 18, 2023 · Medical PolicyBT2020118: IHCP will reimburse EMS provider agencies for administration of vaccinesLowEffective Oct 7, 2020 · Provider BulletinBT202287: IHCP updates age ranges for Moderna COVID vaccine and administration codesMediumEffective Jun 17, 2022 · Provider BulletinBrowse every Indiana Medicaid (IHCP) change in the policy list