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MedicaidCoverageMedium impact

BT202398: IHCP expands coverage for Moderna COVID-19 booster vaccine and administration codes

Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics +1 more·Medical Policy
Effective date
Oct 12, 2022
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP (Indiana Medicaid) now covers Moderna COVID-19 bivalent booster vaccines for members ages 12-17, expanding from the previous 18+ age limit. The vaccine is free but administration can be billed at $36.90 using specific codes.

Action Required

Action needed
Immediately: Update billing system to allow codes 91313 and 0134A for Indiana Medicaid members ages 12-17. Bill vaccine code 91313 at $0 (free vaccine) and administration code 0134A at $36.90. Submit all claims to Gainwell Technologies for professional claims or Optum Rx for pharmacy claims, not to managed care plans. Resubmit any previously denied claims with dates of service on or after Oct 12, 2022.

Affected Billing Codes

91313