Professional Fee Schedule
The Indiana Health Coverage Programs (IHCP) Professional Fee Schedule includes reimbursement information for providers that bill services using professional claims or dental claims reimbursed under the fee-for-service (FFS) delivery system. For each procedure code (and certain procedure-code-modifier combinations), the Professional Fee Schedule lists the reimbursement amount or indicates if the service is noncovered, and also notes additional information, such as if the service requires prior authorization or has age or unit limits.
The entire Professional Fee Schedule can be viewed online, or a search tool is available to view only results for a specific procedure code, code range, or code description. This fee schedule can also be downloaded as a Microsoft Excel document or as a text file that can be imported into popular applications such as Microsoft Access. The Professional Fee Schedule is updated every Tuesday after 4 p.m. with information current as of the previous Sunday.
Outpatient Fee Schedule
The IHCP publishes the rates for outpatient hospitals and ambulatory surgical centers (ASCs) on the Outpatient Fee Schedule. This fee schedule reflects current IHCP coverage and reimbursement policy for procedure codes and revenue codes billed for IHCP outpatient services under the FFS delivery system. It is posted as a Microsoft Excel document, so providers can search and sort as needed. The Outpatient Fee Schedule is updated monthly to reflect any change in policies.