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BT202262: IHCP to cover COVID-19 vaccine for children as young as age 6 months

Indiana Medicaid (IHCP)·IN · Family Medicine, Pediatrics, General Practice·Provider Bulletin
Effective date
Jun 17, 2022
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) will now cover and reimburse COVID-19 vaccines for children as young as 6 months old, effective June 17, 2022. New CPT codes have been established for both Moderna (ages 6 months-5 years) and Pfizer (ages 6 months-4 years) vaccines and their administration, with vaccines provided at no charge and administration reimbursed at $36.90 per dose.

Action Required

Action needed
Immediately: Billing team must update system to include new COVID-19 vaccine codes for children 6 months-5 years. Configure codes 91308, 91311, 0081A-0083A, 0111A-0112A with $36.90 administration fee and $0 vaccine cost. Set age restrictions: Pfizer codes (91308, 0081A-0083A) for ages 6 months-4 years, Moderna codes (91311, 0111A-0112A) for ages 6 months-5 years. Link all codes to revenue code 636. Submit claims to Gainwell Technologies for medical benefit and OptumRx for pharmacy claims.

Affected Billing Codes

91308
91310
91311