MedicaidCoverageMedium impact
BT2023157: IHCP adds coverage for RSV immunization Beyfortus for the pediatric population
Indiana Medicaid (IHCP)·IN · Pediatrics, Family Medicine·Medical Policy
Effective date
Jul 17, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) now covers RSV immunization Beyfortus for children birth to 24 months old, effective July 17, 2023. Providers can bill administration code 96372 but the vaccine itself (codes 90380/90381) reimburse at $0 since the vaccine is available through VFC program.
Action Required
Immediately: Billing team must update system to allow billing CPT 96372 (injection administration) for RSV immunization Beyfortus in children birth to 24 months on Indiana Medicaid. Set codes 90380 and 90381 to $0 reimbursement as vaccine is provided through VFC program. No prior authorization or NDC required. Claims will be automatically reprocessed starting December 20, 2023.