MedicaidCoverageHigh impact
BT202361: IHCP removes coverage for Pfizer and Moderna monovalent COVID-19 vaccine codes
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Apr 18, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) has removed coverage for all Pfizer and Moderna monovalent COVID-19 vaccine codes effective April 18, 2023, following FDA's withdrawal of Emergency Use Authorization. Claims paid after this date will be recouped and reprocessed as denials.
Action Required
Immediately: Stop billing all listed monovalent COVID-19 vaccine codes (91300-91311 and 0001A-0113A) for IHCP patients with dates of service on or after April 18, 2023. Update billing system to block these codes for Indiana Medicaid. Review remittance advices beginning July 19, 2023 for reprocessed denials (ICNs starting with 80) and recoupments (ICNs starting with 52). Switch to billing only bivalent COVID-19 vaccine codes for covered services.