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MedicaidCoverageMedium impact

BT202549: IHCP adds coverage of pneumococcal conjugate vaccine Prevnar 20 (90677) to PE Adult benefit plan

Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Apr 27, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) has added coverage for pneumococcal conjugate vaccine Prevnar 20 (CPT 90677) to the Presumptive Eligibility Adult benefit plan, effective immediately and retroactive to April 27, 2023. The system will automatically reprocess previously denied claims starting May 28, 2025.

Action Required

Action needed
Immediately: Billing team can now submit or resubmit PE Adult claims for CPT 90677 (Prevnar 20 vaccine) retroactively within 180 days of April 22, 2025. Include a copy of bulletin BT202549 when submitting claims beyond standard filing limits. Monitor remittance advices starting May 28, 2025 for automatic adjustments with ICNs beginning with 52 or 80.

Affected Billing Codes

90677