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MedicaidBilling CodesHigh impact

BT2020129: IHCP receives COVID-19 vaccine HCPCS update from CMS and AMA

Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Dec 11, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) now covers COVID-19 vaccination and administration codes effective December 11, 2020. New HCPCS codes are available for Pfizer vaccines (0001A, 0002A, 91300) with Moderna codes pending FDA approval (0011A, 0012A, 91301).

Action Required

Action needed
Immediately: Billing team must add new COVID-19 vaccination HCPCS codes (0001A, 0002A, 91300) to billing system for Indiana Medicaid patients. Submit all managed care member claims to Gainwell Technologies fee-for-service processor, not managed care plans. Use ICD-10 code Z23 for limited benefit programs. Bill vaccine codes at $0 reimbursement but administration codes at specified max fees ($16.94 first dose, $28.39 second dose). Update encounter forms to capture 21-day interval requirement for Pfizer vaccines.

Affected Billing Codes

91300
91301
Z23