MedicaidCoverageMedium impact
BT2025153: IHCP adds coverage for RSV Immunization, Enflonsia (90382)
Indiana Medicaid (IHCP)·IN · Pediatrics, Family Medicine·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 18, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers RSV immunization Enflonsia (CPT 90382) for infants 0 to <8 months old, effective retroactively to July 1, 2025. The vaccine itself reimburses at $0 since it's covered under VFC program, but administration codes 96380 and 96381 with modifier SL are reimbursed at $15 maximum.
Action Required
Immediately: Update billing system to bill CPT 90382 (at $0 reimbursement) for RSV immunization Enflonsia for infants 0 to <8 months. Bill administration using CPT 96380 or 96381 with modifier SL (max $15 reimbursement). For retroactive claims July 1-present, submit within 90 days for managed care or 180 days for FFS, attaching first page of this bulletin for late filing. No prior authorization or NDC required.