MedicaidCoverageMedium impact
BT2022102: IHCP announces pharmacy reimbursement updates for COVID-19 vaccine administration
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Pharmacy
Effective date
Oct 12, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) updated pharmacy reimbursement for COVID-19 vaccines effective October 2022. Bivalent vaccines are now covered for younger age groups (Moderna for ages 6+, Pfizer for ages 5+) and Novavax booster is covered for adults 18+ under specific circumstances.
Action Required
Immediately: Pharmacy billing team must verify eligibility for COVID-19 vaccine administration based on updated age requirements - Moderna Bivalent for members 6+ years, Pfizer Bivalent for members 5+ years (at least 2 months since last dose), and Novavax booster for members 18+ years (at least 6 months since primary series). Contact OptumRx at 855-577-6317 for pharmacy-related questions. Reference BT2022101 for corresponding procedure code updates.