MedicaidCoverageMedium impact
BT2021101: IHCP to cover COVID-19 vaccine for children ages 5 through 11
Indiana Medicaid (IHCP)·IN · Family Medicine, Pediatrics, Internal Medicine +1 more·Provider Bulletin
Effective date
Oct 29, 2021
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP/Medicaid) now covers COVID-19 vaccinations for children ages 5-11 using the Pfizer vaccine. New billing codes are available with $37.21 administration fee, and vaccines must be billed to fee-for-service even for managed care members.
Action Required
Immediately: Billing team must update system to bill COVID-19 vaccine codes 91307, 0071A, and 0072A for children ages 5-11 on Indiana Medicaid. Submit professional claims to Gainwell Technologies (not managed care plans) and pharmacy claims to OptumRx. Update encounter forms to capture age requirements and 21-day dosing interval. Vaccine is $0 cost, administration pays $37.21 maximum.