MedicaidBilling CodesMedium impact
BT2022106: IHCP adds coverage for Moderna and Pfizer COVID-19 bivalent vaccine booster 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
Summary
IHCP (Indiana Medicaid) now covers Moderna and Pfizer COVID-19 bivalent booster vaccines for children ages 5-11 years, adding four new billing codes effective October 12, 2022. The vaccines are provided free with no copay, and administration is reimbursed at $36.90.
Action Required
Immediately: Billing team must add new COVID-19 bivalent booster codes to billing system - use 91314/0144A for Moderna (ages 6-11) and 91315/0154A for Pfizer (ages 5-11). Update encounter forms and staff training. Submit all claims to Gainwell Technologies for professional claims and OptumRx for pharmacy claims, not managed care plans. Link all codes to revenue code 636.