MedicaidCoverageMedium impact
BT2022101: IHCP adds coverage for COVID-19 booster vaccines and administration
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Aug 31, 2022
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers new Pfizer and Moderna bivalent COVID-19 booster vaccines and administration with four new CPT codes. Coverage is retroactive to August 31, 2022, with no prior authorization required and no copay for members.
Action Required
Immediately: Billing team must add new COVID-19 booster codes to system - CPT 91312 and 0124A for Pfizer (age 12+), CPT 91313 and 0134A for Moderna (age 18+). Submit all IHCP COVID-19 vaccination claims to Gainwell Technologies for professional claims and OptumRx for pharmacy claims, not managed care plans. Update encounter forms to include age restrictions and modifier U7 requirement for FSW/CIH Waiver providers.