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MedicaidCoverageLow impact

BT2020118: IHCP will reimburse EMS provider agencies for administration of vaccines

Indiana Medicaid (IHCP)·IN · Emergency Medicine·Provider Bulletin
Effective date
Oct 7, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) will now reimburse EMS provider agencies for vaccine administration services when provided by paramedics or advanced EMTs. EMS agencies must be enrolled under provider specialty 260 (Ambulance) and use specific billing codes with special requirements for members under age 19.

Action Required

Action needed
EMS provider agencies only: If providing vaccine administration services, ensure enrollment under provider specialty 260 (Ambulance) with IHCP. Bill using diagnosis code Z23 and procedure codes 90471-90474. For members age 18 and younger, add SL modifier and ensure vaccine is from VFC program with VFC provider representative present during administration.

Affected Billing Codes

90471
90472
90473
90474
Z23