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MedicaidReimbursementMedium impact

BT202415: IHCP corrects error for VFC vaccine administration code rates

Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP corrected an error where VFC vaccine administration codes (90471, 90472, 90473, 90474 with SL modifier) were incorrectly paid at higher rates starting January 1, 2024. The correct rate is $15 across all Indiana Medicaid programs, and claims will be automatically reprocessed with adjustments appearing on remittance advices starting March 27, 2024.

Action Required

Action needed
By March 27, 2024: Monitor remittance advices for mass adjustments on VFC vaccine administration claims with ICNs/Claim IDs beginning with 52. For underpaid claims, expect additional payments. For overpaid claims, expect 100% recoupment from future claim payments as accounts receivable. No billing changes needed as system corrections are automatic.

Affected Billing Codes

90471
90472
90473
90474