MedicaidBilling CodesHigh impact
BT2021100: IHCP to cover Covid-19 vaccine booster shots
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Oct 20, 2021
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) will now cover COVID-19 vaccine booster shots effective immediately, with specific billing codes for Pfizer, Moderna, and Johnson & Johnson boosters. The policy provides reimbursement rates of $37.21 for administration codes and establishes eligibility criteria for different age groups and risk categories.
Action Required
Immediately: Billing team must update system to bill new COVID-19 booster administration codes (0004A for Pfizer, 0034A for Johnson & Johnson, 0064A for Moderna) at $37.21 reimbursement rate. Submit professional claims to Gainwell Technologies and pharmacy claims to OptumRx. Verify patient eligibility meets CDC/FDA criteria before administration. Update encounter forms with new codes and age/risk requirements.