MedicaidBilling CodesMedium impact
BT2020127: IHCP to reimburse pharmacy providers for COVID-19 vaccine administration
Indiana Medicaid (IHCP)·IN·Pharmacy
Effective date
Dec 15, 2020
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now reimburses pharmacy providers for COVID-19 vaccine administration effective immediately. COVID-19 vaccination claims must be submitted to OptumRx fee-for-service PBM instead of managed care PBMs, with specific billing codes and administration fees ranging from $16.94 to $28.39.
Action Required
Immediately: Pharmacy billing teams must redirect all IHCP COVID-19 vaccination claims from managed care PBMs to OptumRx fee-for-service PBM using BIN 001553 and PCN INM. Use specific Professional Service Code MA with Service Clarification Code 2 for first dose ($16.94 admin fee) and code 6 for second dose ($28.39 admin fee). Submit claims under Dr. Kristina M Box NPI 1730161647 as prescriber until system updates are complete. Claims submitted to managed care PBMs will be denied.