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MedicaidBilling CodesMedium impact

BT2023179: Coverage removed for Pfizer and Moderna COVID-19 vaccination codes; replacement codes provided

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

Summary

Effective November 1, 2023, Indiana Medicaid (IHCP) discontinued coverage for old Pfizer and Moderna COVID-19 vaccination codes and replaced them with streamlined codes. All vaccine product codes now use 913XX series and all administration codes use a single code 90480.

Action Required

Action needed
Immediately: Update billing system to stop using old COVID-19 vaccination codes (91312-91317 and 0121A-0174A series) for dates of service after October 31, 2023. Replace with new codes: 91318-91322 for vaccine products and 90480 for all administration. Update encounter forms and charge masters with new codes. Claims using old codes will be denied by Indiana Medicaid.

Affected Billing Codes

91312
91313
91314
91315
91316
91317
91318
91319
91320
91321
91322
90480