MedicaidCoverageMedium impact
BT2023103: IHCP expands coverage for Vaxneuvance to the pediatric population
Indiana Medicaid (IHCP)·IN · Pediatrics, Family Medicine, General Practice·Medical Policy
Effective date
Jun 17, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) now covers Vaxneuvance pneumococcal vaccine (CPT 90671) for pediatric patients ages 6 weeks and older, effective retroactively to June 17, 2022. Previously denied claims for this age group will be automatically reprocessed.
Action Required
Immediately: Billing team can now submit CPT 90671 claims for IHCP members ages 6 weeks and older. Update billing system age restrictions to allow pediatric billing for this vaccine code. No prior authorization or NDC required. Note quantity limits: 4 doses per lifetime for pediatric members through VFC program, 1 dose per lifetime for adults. Maximum reimbursement is $226.10.