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IHCP Bulletins

Alert: After June 13, 2023, IHCP bulletins will be used to convey news and billing information that would previously have been published in an IHCP banner page. The IHCP banner page was retired June 13, 2023.


Bulletin Spotlight

Indiana Health Coverage Programs (IHCP) bulletins provide official notice of:

  • New and revised policies
  • Changes and reminders related to coverage, billing and claim processing
  • Program updates
  • Information about special initiatives
  • Provider education opportunities

Bulletins are issued on an as-needed basis and typically publish on Tuesdays and Thursdays. To ensure that you don't miss important information, sign up to receive email alerts when new publications, such as bulletins or provider reference modules, are posted to the IHCP website.

All bulletins published from Jan. 1, 2020, through the present can be viewed from the table below. For historic purposes, bulletins issued before 2020 are accessible from the IHCP Bulletin Archive.

You can use the following tool to search all bulletins published since Jan. 1, 2020, for a particular word or phrase. Optionally, you can also include banner pages and/or provider reference modules in your search.

Note: IHCP policies and procedures are subject to change. The most current information about a topic can be found in the related provider reference module or in publications issued after the effective date noted in the module.

Bulletin #

Date

Topic

Audience (Provider Type)

BT20242602/29/2024

IHCP announces updates to physician reimbursement adjustment policies

Behavioral Health, Physician/Practitioner, Other
BT20242502/29/2024

Revised coverage and billing information for the 2024 annual HCPCS codes update

All
BT20242402/29/2024

IHCP to adjust claims for CMHW rate changes

Waiver
BT20242302/29/2024

Pharmacy updates approved by Drug Utilization Review Board February 2024

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20242202/27/2024IHCP announces final EVV implementation timeline and other updatesWaiver
BT20242102/27/2024HCPCS code A4239 added as allowable for DMEClinic; DME/HME; Hospital; Order, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20242002/20/2024FSSA announces health plan selection and enrollment period for PathWays programAll
BT20241902/20/2024IHCP mass adjusts or reprocesses claims for COVID-19 vaccine and administration codesAll
BT20241802/15/2024IHCP corrects errors on the Professional Fee ScheduleAll
BT20241702/15/2024IHCP to begin enrollment for telehealth-only providersAll
BT20241602/15/2024

IHCP announces updated billing guidance for Paxlovid pharmacy claims

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20241502/13/2024IHCP corrects error for VFC vaccine administration code ratesAll
BT20241402/08/2024

IHCP issues TPL exemptions for peer recovery and mobile crisis services

All
BT20241302/06/2024IHCP no longer covers DME codes A9276, A9277 and A9278All
BT20241202/06/2024IHCP changes FQHC/RHC billing guidance for crossover claimsFQHC/RHC
BT20241101/30/2024IHCP updates Structured Family Caregiving claim billing and processing instructionsWaiver
BT20241001/30/2024

IHCP announces retroactive update to HCPCS code J7311

Optometrist
BT20240901/30/2024Pharmacy updates approved by Drug Utilization Review Board January 2024All; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20240801/23/2024IHCP to adjust identified claims for HIP Rate Equalization ProjectAll
BT20240701/23/2024Additional updates made to the October 2023 quarterly HCPCS code updateAll
BT20240601/23/2024IHCP adds coverage for four injectable drugsAll
BT20240501/23/2024

IHCP announces correction to start date of new CMHW rates

Behavioral Health
BT20240401/18/2024

IHCP makes correction to FQHC/RHC COVID-19 vaccine guidance

FQHC/RHC
BT20240301/18/2024

IHCP retires current IHCP Live format, announces IHCP Live: Monthly Townhall

All
BT20240201/18/2024IHCP changes anesthesia conversion factorAnesthesiologist
BT20240101/04/2024

IHCP clarifies prior authorization requirements for ABA therapy services

Behavioral Health
BT202318212/28/2023Coverage and billing information for the 2024 annual HCPCS codes updateAll
BT202318112/28/2023IHCP updates billing guidance for Novavax COVID-19 vaccinationAll
BT202318012/28/2023IHCP PA-UM contractor, Kepro, to officially change name to Acentra Health, Jan. 1All
BT202317912/28/2023Coverage removed for Pfizer and Moderna COVID-19 vaccination codes; replacement codes providedAll
BT202317812/28/2023

Pharmacy updates approved by Drug Utilization Review Board December 2023

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202317712/21/2023CMS approves extension to reimbursement changes for eligible out-of-state children’s hospitalsHospital
BT202317612/19/2023IHCP will reprocess or mass adjust claims for school nursing servicesSchool Corporation
BT202317512/14/2023IHCP clarifies 340B provider billing processClinic, FQHC/RHC, Hospital, Pharmacy/Prescribing, Physician/Practitioner
BT202317412/14/2023

IHCP updates prior authorization requirements for select chiropractic services

Chiropractor
BT202317312/12/2023IHCP covers mobile crisis intervention services retroactive to July 1, 2023Behavioral Health
BT202317212/12/2023IHCP announces new updates to the 2024 Physician Fee ScheduleAll
BT202317112/07/2023IHCP updates requirement for MSRP and cost invoiceAll
BT202317012/05/2023IHCP removes coverage for Janssen dental COVID-19 codesClinic, Dentist, Hospital, Pharmacy/Prescribing, Physician/Practitioner
BT202316911/30/2023IHCP announces fee schedule for ABA therapy services, effective Jan. 1, 2024Behavioral Health
BT202316811/30/2023Pharmacy updates approved by Drug Utilization Review Board November 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202316711/30/2023IHCP follows up on billing issues for Division of Aging rate change itemsWaiver
BT202316611/30/2023CMS announces new provider enrollment application fee for 2024All
BT202316511/30/2023Updated coverage and billing information for the 2023 October HCPCS codesAll
BT202316411/28/2023IHCP advises providers of compliance program resourcesAll
BT202316311/21/2023

IHCP reminds pharmacy providers to submit claims with appropriate DAW codes

Pharmacy/Prescribing
BT202316211/14/2023

IHCP announces pharmacy benefit updates to COVID-19 vaccine reimbursement

Pharmacy/Prescribing
BT202316111/09/2023IHCP clarifies locum tenens healthcare providersChiropractor, Dentist, Optometrist, Physician/Practitioner, Podiatrist
BT202316011/09/2023IHCP requests providers’ feedback on IHCP Quick Hit videosAll
BT202315911/09/2023IHCP adds coverage for RSV vaccine AbrysvoAll
BT202315811/09/2023IHCP adds coverage for RSV vaccine ArexvyAll
BT202315711/09/2023

IHCP adds coverage for RSV immunization Beyfortus for the pediatric population

All
BT202315611/09/2023IHCP to mass adjust claim copaymentsAll
BT202315511/07/2023Fee-for-service claims that denied in error to be mass adjusted or reprocessedAll
BT2023154 11/07/2023Reprocessing claims for the expansion of coverage for Vaxneuvance to the pediatric populationAll
BT202315311/07/2023IHCP permanently removes PA for continued use of respiratory assist devices, services and suppliesAll
BT202315211/02/2023Radiodiagnostic agents newly covered; PA removed for PylarifyAll
BT202315111/02/2023IHCP clarifies weekly reimbursement bundles for OTP servicesHospital; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner; Psych Residential Treatment Facility; Rehabilitation Facility
BT202315011/02/2023

IHCP to revise rates for select DME and medical supply items based on 2024 Medicare rates

DME/HME
BT202314910/31/2023HIP Rate Equalization Project to align rates across all programs, effective Jan. 1, 2024Dentist, DME/HME, Physician/Practitioner, Transportation
BT202314810/31/2023

IHCP to cover weight-loss medications in select cases under EPSDT

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202314710/31/2023IHCP allows reimbursement of cost sharing for dually eligible noncovered IHCP servicesAll
BT202314610/31/2023Pharmacy updates approved by Drug Utilization Review Board October 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202314510/26/2023Date announced for full enforcement of electronic visit verification (EVV) for personal care servicesWaiver
BT202314410/26/2023IHCP expands coverage for Prevnar 20 to the pediatric populationAll, Physician/Practitioner
BT202314310/26/2023IHCP updates age restriction for ICD-10 CM diagnosis code Z00.01All
BT202314210/24/2023

IHCP adds coverage for COVID-19 vaccination and Alzheimer’s treatment codes

All
BT202314110/19/2023CMS approves new rates for DA and DDRS waivers, retroactive to July 1, 2023Waiver
BT202314010/19/2023IHCP updates school nursing servicesSchool Corporation
BT202313910/19/2023IHCP updates the ICD-10 procedure codes for hysterectomyAll, Physician/Practitioner
BT202313810/19/2023IHCP will reprocess or mass adjust claims for select continuous glucose monitor procedure codesAll
BT202313710/19/2023Claims that denied for some rendering providers to be reprocessedAll
BT202313610/17/2023IHCP announces updates to prior authorization and expands criteria for home oxygen policyAll
BT202313510/10/2023IHCP announces hospice rates for federal fiscal year, beginning Oct. 1, 2023Hospice
BT202313410/10/2023

IHCP and Kepro remind providers to use correct NPI and IHCP Provider IDs on PA submissions

All
BT202313310/05/2023OMPP and DFR announce new mailbox for deviation requestsNursing Facility/Long-Term Care
BT202313210/05/2023IHCP announces COVID-19 vaccine pharmacy benefit updates for 2023-2024 seasonPharmacy/Prescribing
BT202313110/05/2023OMPP clarifies request for HIP MCEs to reprocess denied Medicare coinsurance claimsAll
BT202313010/03/2023

IHCP updates transplant guidelines for colon cancer and urine drug screening

Ambulatory Surgical Center, Hospital, Physician/Practitioner
BT202312909/28/2023Annual update of ICD-10 codes is effective Oct. 1, 2023All
BT202312809/28/2023IHCP updates Preferred Diabetes Supplies ListDME/HME; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202312709/28/2023IHCP reminds providers to use their FFS Provider Relations consultantsAll
BT202312609/28/2023IHCP updates DME and HME code tablesDME/HME, Hospital
BT202312509/28/2023Pharmacy updates approved by Drug Utilization Review Board September 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202312409/28/2023IHCP adds coverage for additional wheelchair codesAll
BT202312309/28/2023Coverage and billing information for the 2023 October HCPCS codes updateAll
BT202312209/26/2023Temporary provider enrollment changes ending for rendering providers Oct. 1, 2023All
BT202312109/26/2023IHCP announces changes to ALS and BLS mileage billing requirementsTransportation
BT202312009/21/2023IHCP requests provider feedback on IHCP Provider websiteAll
BT202311909/21/2023IHCP updates FQHC and RHC encounter codesFQHC/RHC
BT202311809/19/2023Long-term care changes being implementedNursing Facility/Long-Term Care
BT202311709/19/2023Claims to be reprocessed after age coverage expansion for Moderna COVID-19 codesAll
BT202311609/14/2023Nursing facilities to maintain calendar year fiscal year for Medicaid cost reportingNursing Facility/Long-Term Care
BT202311509/12/20232023 IHCP Works annual seminar scheduled for October 24-26 in IndianapolisAll
BT202311409/07/2023IHCP summarizes billing guidelines for diabetes testing suppliesDME/HME; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202311309/05/2023Hospice providers to be reimbursed for resident specific add-ons in addition to the daily per diemHospice
BT202311209/05/2023Changes to reimbursement for eligible out-of-state children’s hospitals extendedHospital
BT202311108/31/2023IHCP updates pharmacy benefit long-acting reversible contraceptive coverageOrdering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202311008/31/2023Kepro announces additional Atrezzo Provider Portal training opportunitiesAll
BT202310908/31/2023Adult Mental Health Habilitation State Plan to be renewed Oct. 1, 2023Behavioral Health
BT202310808/31/2023Pharmacy updates approved by Drug Utilization Review Board August 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202310708/31/2023IHCP removes cost-sharing obligations for pharmacist-administered adult vaccinesPharmacy/Prescribing
BT202310608/31/2023IHCP announces new rates for CMHW, effective Oct. 1, 2023Behavioral Health
BT202310508/24/2023

IHCP clarifies documentation requirements for psychiatric inpatient admissions

Behavioral Health, Psych Residential Treatment Facility
BT202310408/22/2023IHCP reminds hospice providers of FFS prior authorization update requirementsHospice
BT202310308/22/2023IHCP expands coverage for Vaxneuvance to the pediatric populationAll
BT202310208/17/2023

Reminder of Indiana nursing facility MDS assessment to require OSA beginning Oct. 1

Nursing Facility/Long-Term Care
BT202310108/17/2023Changes made to cost-sharing due to COVID-19 PHE and HEA 1513All
BT202310008/15/2023Kepro announces additional Atrezzo Portal training opportunitiesAll
BT20239908/15/2023IHCP clarifies billing for medroxyprogesterone acetate injection (HCPCS code J1050)Clinic; FQHC/RHC; Ordering, Prescribing or Referring; Physician/Practitioner
BT20239808/15/2023IHCP expands coverage for Moderna COVID-19 booster vaccine and administration codesAll
BT20239708/15/2023IHCP announces dental coverage policy changesDentist
BT20239608/10/2023IHCP removes PA requirements for newborn or infant frenectomiesDentist
BT20239508/10/2023IHCP has linked procedure code 99236 to revenue code 762Hospital, Physician/Practitioner
BT20239408/08/2023

OMPP requests that HIP MCEs reprocess denied crossover claims

Clinic; FQHC/RHC; Ordering, Prescribing or Referring; Physician/Practitioner
BT20239308/03/2023

IHCP announces home health policy changes

Home Health
BT20239208/03/2023IHCP announces enhancements for fee-for-service prior authorization submissionsAll
BT20239108/03/2023

IHCP assures providers of prior authorization consistency

All
BT20239008/01/2023Pharmacy updates approved by Drug Utilization Review Board July 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20238908/01/2023IHCP revises Hospital Assessment Fee adjustment factor for outpatient and inpatient ratesHospital
BT20238808/01/2023IHCP announces new Sandata Mobile Connect applicationHome Health, Waiver
BT20238707/27/2023

IHCP changes submission requirements for FFS claim administrative review process

All
BT20238607/27/2023

IHCP further extends suspension of MCE PA requirements for respiratory assist devices

DME/HME
BT20238507/27/2023Incorrectly denied electronic crossover claimsAll
BT20238407/27/2023IHCP will mass adjust claims for MFP-CIH code with corrected rateWaiver
BT20238307/25/2023IHCP removes coverage for Janssen COVID-19 vaccine and administration codesAll
BT20238207/20/2023Additional updates made to the July 2023 quarterly HCPCS code updateAll
BT20238107/20/2023IHCP changes end date for COVID-19 testing codesAll
BT20238007/18/2023Qualifying NF providers to receive a resident-specific add-on in addition to the daily per diemNursing Facility/Long-Term Care
BT20237907/13/2023IHCP publishes new Portal Links for Providers webpageAll
BT20237807/11/2023IHCP announces corrections to new rates for DA and DDRS waivers, effective July 1, 2023Waiver
BT20237707/06/2023CMS approves the transportation service for CMHW facility-based respite careWaiver
BT20237607/06/2023IHCP announces transportation provider enrollment changesTransportation
BT202375 06/29/2023Coverage and billing information for the 2023 July quarterly HCPCS codes updateAll
BT20237406/29/2023Reminder: Kepro to begin prior authorization and utilization management responsibilities July 1All
BT20237306/29/2023IHCP to update diagnosis codes on the Emergency Department Autopay List for managed careAll
BT20237206/29/2023Pharmacy updates approved by Drug Utilization Review Board June 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing
BT20237106/29/2023IHCP reminds providers of the Program Integrity self-disclosure processAll
BT20237006/22/2023

IHCP releases frequently asked questions regarding NEMT carve-out changes

Transportation
BT20236906/22/2023

FSSA reminds PRTF providers of rate changes for calendar year 2023

Psych Residential Treatment Facility
BT20236806/20/2023Kepro transition begins July 1; additional Atrezzo Provider Portal benefits announcedAll
BT20236706/20/2023MUEs updated for procedure codes linked to revenue code 762, retroactive to Jan.1, 2023Outpatient
BT20236606/20/2023Save the date for the 2023 IHCP Works annual seminarAll
BT20236506/15/2023Atlas quality measurement system for addiction treatment facilities enrollment deadline is June 30Behavioral Health
BT20236406/15/2023IHCP adding coverage for mobile crisis intervention servicesBehavioral Health, Clinic, FQHC/RHC, Hospital, Physician/Practitioner, Psych Residential Treatment Facility, Rehabilitation Facility, Transportation, Other
BT20236306/13/2023IHCP PA-UM contractor, Kepro, officially changes its name to Acentra HealthAll
BT20236206/13/2023IHCP adds coverage for plasma-based genomic testing for individuals with advanced solid cancersAll
BT20236106/13/2023IHCP removes coverage for Pfizer and Moderna monovalent COVID-19 vaccine codesAll; Clinic; Hospital; Ordering, Prescribing or Referring; Physician/Practitioner
BT20236006/08/2023Program Integrity reminds providers about the prepayment review process and requirementsAll
BT20235906/06/2023IHCP announces new rates for DA and DDRS waivers, effective July 1, 2023Waiver
BT20235806/06/2023IHCP to retire banner pages June 13All
BT20235706/01/2023IHCP adopts weekly reimbursement bundles for OTP servicesHospital; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner; Psych Residential Treatment Facility; Rehabilitation Facility
BT20235606/01/2023IHCP updates school-based services policySchool Corporation
BT20235506/01/2023IHCP will host webinars to discuss the NEMT brokerage carve-out policy changesNursing Facility/Long Term Care, Other
BT20235406/01/2023Home health rates are changing effective July 1, 2023Home Health
BT20235305/30/2023Nonemergency ALS and BLS ambulance transports for FFS members will not be brokered through VeridaAll, Transportation
BT20235205/30/2023NEMT services for FFS members residing in nursing facilities will not be brokered through VeridaNursing Facility/Long Term Care, Transportation
BT20235105/30/2023Pharmacy updates approved by Drug Utilization Review Board May 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing
BT20235005/30/2023IHCP updates PA criteria for HCPCS code J1305 (Evkeeza)Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20234905/25/2023IHCP Member and Provider Customer Assistance phone lines will be closed Friday, June 2All
BT20234805/23/2023IHCP adds new transportation service for CMHW facility-based respite careWaiver
BT20234705/23/2023FSSA renews CMHW State Plan benefitBehavioral Health, Waiver, Other
BT20234605/16/2023CoreMMIS and the IHCP Portal are migrating to Amazon Web ServicesAll
BT20234505/16/2023Updates to the coverage and billing information for the 2023 April quarterly HCPCS code updateAll
BT20234405/16/2023IHCP updates age ranges for Pfizer COVID-19 procedure codes retroactive to CMS effective dateAll
BT20234305/11/2023IHCP establishes rates for coordinating benefits for global maternity codesAll
BT20234205/11/2023IHCP rescinds temporary presumptive eligibility application changesBehavioral Health, Clinic, FQHC/RHC, Hospital, Physician/Practitioner, Psych Residential Treatment Facility
BT20234105/02/2023Indiana nursing facility MDS assessment to require Optional State Assessment beginning Oct. 1Nursing Facility/Long-Term Care
BT20234005/02/2023IHCP adds coverage for procedure code G0433All
BT20233905/02/2023OMPP and Kepro announce training plan and dates for Atrezzo Provider PortalAll
BT20233805/02/2023IHCP issues reimbursement updates for COVID-19 vaccine administrationAll
BT20233705/02/2023Pharmacy updates approved by Drug Utilization Review Board April 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20233604/27/2023DDRS and IHCP announce changes to day habilitation and prevocational servicesWaiver
BT20233504/27/2023IHCP updates hysterectomy policyAll
BT20233404/25/2023Third-dose administration of Moderna COVID-19 vaccine covered for ages 6 months through 5 yearsAll
BT20233304/25/2023Booster administration of Pfizer COVID-19 bivalent vaccine covered for ages 6 months through 4 yearsAll
BT20233204/25/2023IHCP expands procedure code Q3014 to additional providersBehavioral Health, Clinic, Physician/Practitioner
BT20233104/20/2023IHCP introduces a new provider self-service IVR system called GABBYAll
BT20233004/11/2023IHCP to rescind 1135 waivers due to the ending public health emergencyAll
BT20232904/04/2023

FSSA makes changes to pharmacy supply limits for HIP Basic members

All
BT20232803/30/2023Coverage and billing information for the 2023 April quarterly HCPCS codes updateAll
BT20232703/30/2023IHCP to stop recognizing temporary COVID-19 licenses May 11, 2023All
BT20232603/30/2023Semiannual update of ICD-10 codes is effective April 1, 2023All
BT20232503/30/2023Pharmacy updates approved by Drug Utilization Review Board March 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20232403/21/20232023 IHCP Roadshow to be held in April and MayAll
BT20232303/14/2023FSSA announces CMS approval for LARC device carve-out for FQHC and RHC providersFQHC/RHC
BT20232203/09/2023IHCP announces changes to reimbursement for EMS providersTransportation
BT20232103/09/2023FSSA recommends managed care entities to serve future Indiana Pathways for Aging membersAll
BT20232003/09/2023IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2023DME/HME
BT20231903/09/2023IHCP introduces new program for qualified members losing HIP eligibilityAll
BT20231803/09/2023IHCP rescinds temporary provider enrollment changesAll
BT20231703/07/2023IHCP updates specified genetic testing policiesAmbulatory Surgical Center, Clinic, Hospital, Laboratory, Physician/Practitioner
BT202316 02/28/2023Additional updates made for select annual 2023 HCPCS codesAll
BT20231502/28/2023Medicaid member eligibility review actions to resumeAll
BT20231402/28/2023Pharmacy updates approved by Drug Utilization Review Board February 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20231302/28/2023IHCP to allow enrollment for Medicare-only providersAll
BT20231202/21/2023IHCP updates Notification of Pregnancy billing guidelinesClinic, FQHC/RHC, Hospital, Physician/Practitioner
BT20231102/07/2023IHCP announces EVV explanation of benefits recoupment codesWaiver
BT20231002/02/2023IHCP announces changes to reimbursement for EMS providersTransportation
BT20230901/31/2023FSSA announces changes to LARC device billing for FQHC and RHC providersFQHC/RHC
BT20230801/26/2023Coverage added for COVID-19 bivalent vaccines and administration for children as young as 6 monthsAll
BT20230701/26/2023IHCP extends suspension of MCE PA requirements for respiratory assist devicesDME/HME
BT20230601/26/2023Pharmacy updates approved by Drug Utilization Review Board January 2023Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT20230501/26/2023Coverage information corrected for annual 2023 HCPCS code 0739TAll
BT20230401/24/2023IHCP announces end to member continuous eligibilityAll
BT20230301/19/2023IHCP eligibility requirements for former foster care youth are changingClinic, FQHC/RHC, Hospital, Physician/Practitioner, Other
BT20230201/12/2023IHCP updates blood lead testing policyClinic, FQHC/RHC, Laboratory, Physician/Practitioner
BT20230101/10/2023Kepro to serve as new fee-for-service IHCP prior authorization and utilization management vendorAll
BT202212112/29/2022Coverage and billing information for the 2023 annual HCPCS codes updateAll
BT202212012/29/2022Changes made to outlier reimbursement for eligible out-of-state children’s hospitalsHospital
BT202211912/29/2022IHCP revises recently announced Preferred Diabetes Supply List updatesDME/HME; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202211812/29/2022Pharmacy updates approved by Drug Utilization Review Board December 2022Ordering, Prescribing or Referring;Pharmacy/Prescribing;Physician/Practitioner
BT202211712/20/2022Managed care programs will follow the same utilization management hierarchyAll
BT202211612/15/2022IHCP removing coverage of COVID-19 treatment codes for bebtelovimabAll
BT202211512/15/2022IHCP to add coverage for nucleic acid amplification tests for bacterial vaginitisAmbulatory Surgical Center; Clinic; FQHC/RHC; Hospital; Laboratory; Ordering, Prescribing or Referring; Physician/Practitioner
BT202211412/13/2022IHCP to begin recouping payments due to EVV noncomplianceWaiver
BT202211312/13/2022IHCP updates Preferred Diabetes Supply ListDME/HME; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT202211212/08/2022CMS announces new provider enrollment application fee for 2023All
BT2022111 12/01/2022 IHCP revises dental coding update Dentist
BT2022110 12/01/2022 Pharmacy updates approved by Drug Utilization Review Board November 2022 Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner
BT2022109 11/29/2022 IHCP updates coverage for behavioral health diagnosis codes Behavioral Health
BT2022108 11/29/2022 IHCP revises billing guidance for pediatric vaccine counseling services All
BT2022107 11/29/2022 Caregiver Coaching and Behavior Management service added for A&D waiver Waiver
BT2022106 11/29/2022 IHCP adds coverage for Moderna and Pfizer COVID-19 bivalent vaccine booster codes All
BT2022105 11/29/2022 IHCP adds coverage for Novavax COVID-19 booster vaccine All
BT2022104 11/22/2022 HCBS providers can apply for Direct Service Workforce Investment Grant by Dec. 22 All
BT2022103 11/17/2022 IHCP clarifies customized wheelchair billing for members residing in a nursing facility All
BT2022102 11/17/2022 IHCP announces pharmacy reimbursement updates for COVID-19 vaccine administration Pharmacy/Prescribing
BT2022101 11/17/2022 IHCP adds coverage for COVID-19 booster vaccines and administration All
BT2022100 11/15/2022 IHCP updates guidance for tobacco dependence individual and group counseling sessions Transportation
BT202299 11/10/2022 IHCP to add coverage for monkeypox testing and vaccine Ambulatory Surgical Center; Audiologist; Chiropractor; Clinic; Dentist; End-Stage Renal Disease Clinic; FQHC/RHC; Hospital; Optometrist; Optician; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Podiatrist; Therapist; Transportation; Waiver
BT202298 11/10/2022 IHCP COVID-19 Response: Nov. 28 is new deadline for submitting “Sprinter” ambulance grant applications Transportation
BT202297 11/08/2022 IHCP expands and clarifies telehealth coverage Addiction Services; Audiologist; Chiropractor; Clinic; Dentist; End-Stage Renal Disease Clinic; FQHC/RHC; Hospital; Behavioral Health; Optometrist; Optician; Ordering, Prescribing or Referring; Physician/Practitioner; Podiatrist; Therapist
BT202296 11/08/2022 IHCP updates physician-administered drug PA criteria and diagnosis restrictions Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202295

11/01/2022

IHCP updates prenatal tests and screening policies

Ambulatory Surgical Center, Chiropractor, Clinic, Dentist, FQHC/RHC, Hospital, Laboratory, Optometrist, Physician/Practitioner, Podiatrist, Therapist

BT202294

11/01/2022

Pharmacy updates approved by Drug Utilization Review Board October 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202293

11/01/2022

PRTF leave days and billing clarified

Psychiatric Residential Treatment Facility

BT202292

10/27/2022

IHCP COVID-19 Response: IHCP announces HME/DME stabilization grants

DME/HME, Hearing Aid Dealer, Pharmacy/Prescribing

BT202291

10/27/2022

IHCP announces dental coding policy changes

Dentist

BT202290

10/11/2022

CMS releases new federal hospice rates for federal fiscal year 2023

Hospice

BT202289

10/06/2022

IHCP to expand age ranges for Novavax COVID-19 vaccine and administration procedure codes

All

BT202288

10/04/2022

Annual update of ICD-10 codes is effective Oct. 1, 2022

All

BT202287

10/04/2022

IHCP updates age ranges for Moderna COVID vaccine and administration codes

Clinic, Hospital, Physician/Practitioner

BT202286

10/04/2022

IHCP updates clinical trial policy

All

BT202285

09/29/2022

Coverage and billing information for the 2022 October quarterly HCPCS codes update

All

BT202284

09/29/2022

HCBS providers are eligible to apply for LTSS readiness grant by Oct. 21

Waiver

BT202283

09/29/2022

2023 annual ICD update delayed

All

BT202282

09/29/2022

Pharmacy updates approved by Drug Utilization Review Board September 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202281

09/27/2022

IHCP announces second round of provider engagement sessions for HCBS LTSS providers

Waiver

BT202280

09/27/2022

IHCP to enroll donor milk banks

DME/HME

BT202279

09/22/2022

IHCP announces pharmacy reimbursement for COVID-19 bivalent booster administration

Pharmacy/Prescribing

BT202278

09/20/2022

IHCP expands stand-alone COVID-19 vaccine counseling for EPSDT-eligible members

Pharmacy/Prescribing

BT202277

09/20/2022

IHCP announces changes to future HIP reimbursement rates

All

BT202276

09/15/2022

IHCP announces EVV home health policy details

Home Health

BT202275

09/15/2022

IHCP announces new provider readiness training schedule for HCBS Long-Term Services and Supports Providers

Waiver

BT202274

09/15/2022

IHCP to reimburse HCPCS code Q0222

Clinic, Hospital, Physician/Practitioner

BT202273

09/08/2022

HCBS Type II Sprinter ambulance grant

Transportation

BT202272

08/30/2022

IHCP announces update to Novavax COVID-19 vaccine pharmacy claim reimbursement

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202271

08/30/2022

Pharmacy updates approved by Drug Utilization Review Board August 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202270

08/30/2022

IHCP announces intent to implement Statewide Uniform PDL for all Medicaid pharmacy plans

All

BT202269

08/30/2022

IHCP to update age range for dental COVID-19 vaccine

Dental

BT202268

08/25/2022

2022 IHCP Works annual seminar scheduled for October 11-13 in Indianapolis

All

BT202267

08/25/2022

IHCP to cover Novavax COVID-19 vaccine and administration

Ambulatory Surgical Center; Clinic; FQHC/RHC; Ordering, Prescribing or Referring (OPR); Pharmacy/Prescribing; Physician/Practitioner; Transportation

BT202266

08/16/2022

IHCP announces billing guidance for Paxlovid pharmacy claims

Pharmacy/Prescribing

BT202265

08/16/2022

IHCP updates PA criteria for HCPCS code J3399 (Zolgensma)

Hospital; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202264

08/16/2022

HIP reimbursement policy updated for members requiring admission to LTC facilities

Nursing Facility/Long-Term Care, Other

BT202263

08/11/2022

IHCP expands practitioners allowed to order speech pathology services

Home Health, Physician/Practitioner, Therapist

BT202262

08/09/2022

IHCP to cover COVID-19 vaccine for children as young as age 6 months

All

BT202261

07/28/2022

IHCP revises Hospital Assessment Fee adjustment factors for outpatient and inpatient rates

All

BT202260

07/28/2022

IHCP temporarily suspends MCE PA requirements for respiratory assist devices

DME/HME

BT202259

07/28/2022

IHCP adds coverage for CT colonography screenings

Clinic, Hospital, Physician/Practitioner, Radiology

BT202258

07/21/2022

OMPP clarifies care coordination policies with MCEs

All

BT202257

07/19/2022

IHCP COVID-19 Response: August 12 is new deadline for HCBS wheelchair van and lift grant applications

Transportation

BT202256

07/19/2022

IHCP establishes new Presumptive Eligibility rules for backdating and who can fill out an application

Behavioral Health, Clinic, FQHC/RHC, Hospital, Physician/Practitioner, Other

BT202255

07/19/2022

IHCP clarifies prior authorization criteria for specialized car seats and car beds

DME/HME; Ordering, Prescribing or Referring; Physician/Practitioner

BT202254

07/19/2022

IHCP updates FQHC and RHC encounter codes

FQHC/RHC

BT202253

07/14/2022

IHCP allows new POS code for FQHCs and RHCs July 21

FQHC/RHC

BT202252

07/07/2022

IHCP authorizes palivizumab RSV prophylaxis for high-risk IHCP members

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202251

06/30/2022

Coverage and billing information for the July 2022 quarterly HCPCS codes update

All

BT202250

06/30/2022

Reimagining training materials for provider readiness in the transition to MLTSS

Home Health, Nursing Facility/Long Term Care, Waiver, DME/HME

BT202249

06/30/2022

IHCP adds additional coverage in response to SEA 284 telehealth billing guidance

Behavioral Health

BT202248

06/30/2022

IHCP announces date of full enforcement of EVV for personal care services and other updates

Waiver

BT202247

06/28/2022

IHCP to cover COVID-19 vaccine counseling as part of EPSDT benefit

Physician/Practitioner

BT202246

06/28/2022

Pharmacy updates approved by Drug Utilization Review Board June 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202245

06/16/2022

IHCP COVID-19 Response: IHCP announces HCBS wheelchair van and lift grants – apply by July 22

Transportation

BT202244

06/16/2022

IHCP updates PA criteria for HCPCS code Q2042 (Kymriah)

Hospital; Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202243

06/07/2022

IHCP adds coverage for G2213 for opioid treatment in the emergency department

Addiction Services, Clinic, Physician/Practitioner, Psych Residential Treatment Facility, Rehabilitation Facility

BT202242

05/31/2022

IHCP revises home oxygen PA criteria

DME/HME, Home Health

BT202241

05/31/2022

Pharmacy updates approved by Drug Utilization Review Board May 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202240

05/26/2022

IHCP revises bariatric surgery PA criteria

Hospital, Physician/Practitioner

BT202239

05/19/2022

IHCP announces final 2022 telehealth and virtual services code set

All

BT202238

05/17/2022

IHCP establishes billing and prior authorization requirements for RPM services

All

BT202237

05/17/2022

Additional COVID-19 vaccine and administration codes covered for Moderna second booster shots

All

BT202236

05/10/2022

IHCP COVID-19 Response: Deadline extended to May 23 to submit application for HCBS ambulance grants

Transportation

BT202235

05/05/2022

IHCP rescinds additional service locations per COVID-19 waiver – effective June 6

Hospital, Nursing Facility/Long-Term Care, Psych Residential Treatment Facility, Rehabilitation Facility

BT202234

04/28/2022

IHCP announces additional HCBS managed care training opportunities

Home Health, Nursing Facility/Long-Term Care, Waiver, DME

BT202233

04/26/2022

IHCP COVID-19 Response: Deadline extended to May 9 to submit application for HCBS ambulance grants

Transportation

BT202232

04/26/2022

FSSA clarifies virtual case management services per SEA 284

Behavioral Health, Waiver

BT202231

04/26/2022

IHCP clarifies service limitations for chiropractic services

Chiropractor

BT202230

04/21/2022

IHCP updates reimbursement policy regarding aducanumab (Aduhelm) coverage

Ordering, Prescribing or Referring; Physician/Practitioner

BT202229

04/14/2022

Manual pricing reimbursement information for select April 2022 quarterly HCPCS codes

Clinic, DME/HME, Optometrist, Optician

BT202228

04/12/2022

Additional providers may order diabetes self-management and training services

Clinic, Hospital, Physician/Practitioner, Podiatrist

BT202227

03/31/2022

Coverage and billing information for the April 2022 quarterly HCPCS code update

All

BT202226

03/31/2022

FSSA extends postpartum coverage period to 12 months

All

BT202225

03/31/2022

Pharmacy updates approved by Drug Utilization Review Board March 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202224

03/31/2022

Pharmacy claim processing clarified for administration of third and booster doses of COVID-19 vaccine

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202223

03/31/2022

2022 IHCP Roadshow to be held May 4 and 5

All

BT202222

03/24/2022

IHCP COVID-19 Response: IHCP announces HCBS bariatric ambulance grants to Indiana

Transportation

BT202221

03/22/2022

IHCP clarifies prior authorization for certain DME or HME supplies and services

DME/HME

BT202220

03/15/2022

IHCP announces spring/summer HCBS business acumen training schedule

Waiver

BT202219

03/10/2022

FSSA selects managed care entities to serve Healthy Indiana Plan and Hoosier Healthwise members

All

BT202218

03/03/2022

IHCP to cover additional COVID-19 vaccine and administration codes

All

BT202217

03/01/2022

IHCP updates PA policy for AED and WCD devices

DME/HME

BT202216

03/01/2022

Pharmacy updates approved by Drug Utilization Review Board February 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202215

03/01/2022

IHCP rescinds certain temporary COVID-19 policy changes

All

BT202214

02/24/2022

OMPP is making changes to billing and reimbursement for TBI facility services

Rehabilitation Facility

BT202213

02/22/2022

IHCP to resume RSV season limits for palivizumab PA requests

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202212

02/15/2022

Changes made to MRO services in response to HEA 1468

Behavioral Health

BT202211

02/10/2022

FQHC/RHC supplemental (wraparound) manual payment requests end for managed care claims

FQHC/RHC

BT202210

02/08/2022

IHCP revises VFC program policy for pharmacies

Pharmacy/Prescribing

BT202209

02/03/2022

Outpatient reimbursement information updated for select annual 2022 HCPCS codes

Ambulatory Surgical Center, Clinic, End-Stage Renal Disease Clinic, Hospital

BT202208

02/01/2022

IHCP to reimburse pharmacy providers for select COVID-19 tests

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202207

02/01/2022

Pharmacy updates approved by Drug Utilization Review Board January 2022

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202206

01/25/2022

IHCP covers additional COVID-19 treatment codes M0220, M0221 and Q0220

Ambulatory Surgical Center, Clinic, FQHC/RHC, Hospital, Physician/Practitioner

BT202205

01/20/2022

IHCP excludes electronic visit verification requirement in 24-hour congregate settings

Waiver

BT202204

01/20/2022

IHCP COVID-19 Response: IHCP updates procedure code for remdesivir administration

Clinic, Hospital, Physician/Practitioner

BT202203

01/11/2022

IHCP COVID-19 Response: IHCP announces HCBS stabilization grants

Behavioral Health, Home Health, School Corporation, Waiver

BT202202

01/05/2022

IHCP COVID-19 Response: IHCP revises remdesivir administration reimbursement policy

Hospital; Ordering, Prescribing or Referring (OPR); Pharmacy/Prescribing; Physician/Practitioner

BT202201

01/04/2022

Pharmacy updates approved by Drug Utilization Review Board December 2021

Pharmacy/Prescribing, Physician/Practitioner

BT2021113

12/30/2021

Coverage and billing information for the 2022 annual HCPCS codes update

All

BT2021112

12/30/2021

IHCP requests feedback for proposed 2022 telehealth and virtual services code set

All

BT2021111

12/30/2021

DMHA announces changes to child mental health wraparound access site policy

Waiver

BT2021110

12/30/2021

Drug coverage policy clarified for members enrolled in managed care requiring admission to LTC facilities

Pharmacy, Prescribing

BT2021109

12/21/2021

IHCP clarifies MCE network participation request effective date policy

All

BT2021108

12/14/2021

Changes to reimbursement for eligible out-of-state children’s hospitals

All

BT2021107

12/07/2021

Quarterly cost sharing cap to include M.E.D. Works premiums in January 2022

All

BT2021106

12/02/2021

IHCP to implement third-party liability cost avoidance on prenatal care claims

Physician/Practioner

BT2021105

12/02/2021

Pharmacy updates approved by Drug Utilization Review Board November 2021

Pharmacy, Prescribing

BT2021104

11/30/2021

IHCP establishes MCE network participation request effective date policy

All

BT2021103

11/23/2021

Additional changes being made to CIH and FSW services, effective Jan. 1, 2022

Waiver

BT2021102

11/23/2021

IHCP adds coverage for COVID-19 laboratory service codes 0240U and 0241U

Clinic, Hospital, Laboratory

BT2021101

11/16/2021

IHCP to cover COVID-19 vaccine for children ages 5 through 11

Ambulatory Surgical Center, Clinic, FQHC/RHC, Hospital, Pharmacy/Prescribing, Physician/Practitioner, Podiatrist, School Corporation, Transportation, Waiver

BT2021100

11/16/2021

IHCP to cover Covid-19 vaccine booster shots

Ambulatory Surgical Center, Clinic, FQHC/RHC, Hospital, Pharmacy/Prescribing, Physician/Practitioner, Podiatrist, School Corporation, Transportation, Waiver

BT202199

11/16/2021

IHCP clarifies billing requirements for enrolled behavioral health professionals supervising plans of treatment

Behavioral Health

BT202198

11/04/2021

IHCP updates PA criteria for HCPCS code Q2041 (Yescarta)

Physician/Practitioner

BT202197

11/04/2021

CMS announces new provider enrollment application fee for 2022

All

BT202196

11/02/2021

IHCP adds coverage for COVID-19 vaccine counseling, effective Nov. 2, 2021

Ambulatory Surgical Center, Clinic, Hospital, Physician/Practitioner, Other

BT202195

10/28/2021

Pharmacy updates approved by Drug Utilization Review Board October 2021

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202194

10/21/2021

CMS releases new federal hospice rates for federal fiscal year 2022

Hospice

BT202193

10/14/2021

IHCP corrects ICD-10 codes for Presumptive Eligibility for Pregnant Women

All

BT202192

10/14/2021

IHCP Presumptive Eligibility benefits, coverage categories and effective dates

All

BT202191

10/05/2021

IHCP announces the Indiana Pregnancy Promise Program

All, Behavioral Health, Physician/Practitioner

BT202190

09/30/2021

Coverage and billing information for the October 2021 HCPCS code update

All

BT202189

09/30/2021

Pharmacy updates approved by Drug Utilization Review Board September 2021

Ordering, Prescribing or Referring; Pharmacy/Prescribing

BT202188

09/28/2021

IHCP COVID-19 Response: Virtual services reimbursed during COVID-19 public health emergency

Waiver

BT202187

09/28/2021

FQHC/RHC wraparound supplemental dental claim processing change

FQHC, RHC

BT202186

09/23/2021

Annual update of ICD-10 codes is effective Oct. 1, 2021

All

BT202185

09/20/2021

IHCP COVID-19 Response: Reimbursement temporarily increased for COVID-19 Ready nursing facilities

Nursing Facility, Long-Term Care

BT202184

09/16/2021

IHCP to implement PreCheck MyScript® for FFS pharmacy benefit

All, Pharmacy, Prescribing

BT202183

09/14/2021

IHCP updates PA and billing requirements for urine drug testing, effective Oct. 15, 2021

All

BT202182

09/08/2021

IHCP COVID-19 Response: IHCP temporarily reinstates PA policy for LTAC and AIR facility admissions

Hospital, Other

BT202181

09/08/2021

IHCP COVID-19 Response: IHCP reinstates temporary PA changes for managed care SNF admissions

Nursing Facility/Long-Term Care

BT202180

09/08/2021

IHCP COVID-19 Response: PA changes temporarily reinstated for some DME/HME supplies and services

DME/HME

BT202179

09/08/2021

IHCP COVID-19 Response: IHCP reinstates inpatient SUD and psychiatric admission policy changes

Behavioral Health, Psych

BT202178

09/07/2021

IHCP COVID-19 Response: IHCP temporarily revises time frames for certain PA approvals

All

BT202177

09/07/2021

2021 IHCP Works seminar to be held virtually Oct. 5-7

All

BT202176

09/07/2021

Presumptive Eligibility changing for pregnant adults who were formerly in foster care

PE certified

BT202175

08/31/2021

Pharmacy update approved by Drug Utilization Review Board August 2021

Pharmacy, Prescribing

BT202174

08/30/2021

IHCP temporarily reinstates revisions to PA process for acute care hospital non-elective inpatient admissions

All

BT202173

08/24/2021

IHCP updates PEPW and PE applications to include option for text messages; revises acceptance letters

Clinic, FQHC/RHC, Physician/Practitioner, Waiver, Other

BT202172

08/24/2021

IHCP to reimburse administration for third dose of specified COVID-19 vaccines

Clinic, FQHC/RHC, Hospital, Pharmacy/Prescribing, Physician/Practitioner, Waiver, EMS, Other

BT202171

08/17/2021

IHCP updates cervical arthroplasty PA criteria

Physician/Practitioner

BT202170

08/17/2021

IHCP covers additional COVID-19 treatment codes M0249, M0250 and Q0249

All

BT202169

08/12/2021

IHCP announces additional providers may submit PA requests

All

BT202168

08/05/2021

Licensed addiction counselor associates able to provide counseling in an OTP, effective Sept. 5

Behavioral Health

BT202167

08/05/2021

IHCP clarifies rescinded COVID-19 policies

All, Home Health, Transportation

BT202166

08/03/2021

FSSA reminds PRTF providers of rate changes for 2021

Psych Residential Treatment Facility

BT202165

08/03/2021

IHCP pharmacy benefits resumes pre-COVID-19 policies

Ordering, Prescribing or Referring; Pharmacy/Prescribing

BT202164

07/29/2021

IHCP announces limited opportunity for new independent external reviews

All

BT202163

07/27/2021

IHCP revises the NPI reporting requirements for enrolling providers

All

BT202162

07/27/2021

Pharmacy updates approved by Drug Utilization Review Board July 2021

Pharmacy/Prescribing

BT202161

07/27/2021

IHCP rescinds temporary provider enrollment COVID policies

All

BT202160

07/22/2021

CMS clarifies that MCEs can continue to bypass NCCI edit causing NOP claims to deny

All

BT202159

07/20/2021

OMPP announces Targeted Probe Education program

All

BT202158

07/20/2021

IHCP updates Outpatient Fee Schedule

All

BT202157

07/13/2021

IHCP aligns PA criteria for nusinersen (Spinraza)

Ordering, Prescribing or Referring; Pharmacy/Prescribing; Physician/Practitioner

BT202156

07/08/2021

Coverage and billing information for the July 2021 HCPCS code update

All

BT202155

07/08/2021

OMPP announces due dates and reinstatement penalties for LTC providers

Nursing Facility, Long-Term Care, ICF/IID

BT202154

07/06/2021

IHCP informs pharmacy providers of the billing specifications for prescription origin codes

Pharmacy, Prescribing

BT202153

07/06/2021

Providers may now request palivizumab RSV prophylaxis for high-risk IHCP members

Pharmacy, Prescribing

BT202152

07/01/2021

IHCP rescinds certain COVID-19 policy changes

All

BT202151

07/01/2021

Pharmacy updates approved by Drug Utilization Review Board June 2021

OPR, Pharmacy/Prescribing, Physician/Practitioner

BT202150

06/29/2021

Save the date for the 2021 IHCP Works Seminar

All

BT202149

06/24/2021

IHCP to end 3 percent reduction in reimbursement for hospital services

Hospital

BT202148

06/24/2021

IHCP to end 3 percent rate reduction in reimbursement for nursing facilities

Nursing facility, Long-term care

BT202147

06/24/2021

Home health rates for state fiscal years 2022 and 2023 are effective July 1, 2021

Home Health

BT202146

06/22/2021

Notification of Pregnancy code and modifier (99354 TH) denying for NCCI MUE

Physician/Practitioner

BT202145

06/17/2021

IHCP clarifies effective dates for telehealth policy updates

All

BT202144

06/15/2021

FQHC/RHC wraparound supplemental professional claim processing to change July 1

FQHC/RHC

BT202143

06/10/2021

IHCP clarifies physical medical care requirements for behavioral health professionals

Behavioral Health

BT202142

06/08/2021

IHCP announces policy update for telehealth services

All

BT202141

06/03/2021

IHCP updates FQHC and RHC encounter codes

FQHC, RHC

BT202140

06/01/2021

Pharmacy updates approved by Drug Utilization Review Board May 2021

Pharmacy, Prescribing

BT202139

05/28/2021

IHCP introduces new process for submitting Policy Consideration requests

All

Bt202138

05/27/2021

IHCP announces changes to 2022 contracts for Medicare Advantage plans focused on dually eligible members

All

BT202137

05/25/2021

Expanded scope of licensed behavioral health professionals to certify a mental health diagnosis

Behavioral Health

BT202136

05/18/2021

IHCP COVID-19 Response: IHCP announces EMS provider relief; apply by July 31, 2021

EMS, Transportation

BT202135

05/04/2021

IHCP clarifies PA criteria for HCPCS code J0791

Physician/Practitioner

BT202134

04/27/2021

Pharmacy updates approved by Drug Utilization Review Board April 2021

Pharmacy, Prescribing

BT202133

04/22/2021

Rates corrected for certain DME codes

DME/HME

BT202132

04/20/2021

Pharmacies required to use Compound Ingredient Drug Cost field; reimbursement methodology updated

Pharmacy, Prescribing

BT202131

04/13/2021

2021 IHCP Roadshow kicks off April 27

All

BT202130

04/08/2021

IHCP provides billing guidance for attendant care transportation options

Waiver

BT202129

04/08/2021

DDRS waiver providers to provide COVID-19 vaccines to eligible FSW and CIH waiver members

Waiver

BT202128

04/01/2021

Coverage and billing information for the April 2021 HCPCS codes update

All

BT202127

04/01/2021

CMS approves FSSA request for attendant care transportation options

Waiver

BT202126

03/30/2021

Additional codes covered for COVID-19 vaccine and treatment

All

BT202125

03/30/2021

Pharmacy updates approved by Drug Utilization Review Board March 2021

Pharmacy, Prescribing

BT202124

03/30/2021

IHCP clarifies rental periods of DME capped rental items submitted on or after April 1, 2021

DME/HME

BT202123

03/30/2021

UnitedHealthcare begins as a new MCE for Hoosier Care Connect on April 1, 2021, with open network

All

BT202122

03/30/2021

Corrected outpatient reimbursement information provided for select annual 2021 HCPCS codes

All

BT202121

03/25/2021

COVID-19 vaccine administration billing for FQHC and RHC providers clarified

FQHC, RHC

BT202120

03/23/2021

IHCP announces new revised E/M codes for office visits

All, Chiropractor, Clinic, Mental Health, Physician/Practitioner, Podiatrist

BT202119

03/23/2021

Case/care manager information is available in eligibility information for waiver and MRO benefits

HCBS waiver, MRO

BT202118

03/23/2021

Reimbursement updates for COVID vaccine administration

All

BT202117

03/11/2021

Third-Party Liability Disallowance Project supports proper billing of Medicaid claims

All

BT202116

03/04/2021

Additional billing instructions presented for EMS treat-no-transport and naloxone administration

Transportation, EMS

BT202115

03/02/2021

Pharmacy updates approved by Drug Utilization Review Board February 2021

Pharmacy, Prescribing

BT202114

03/02/2021

IHCP announces special selection period for Hoosier Care Connect members

All

BT202113

02/25/2021

Compounds submitted with unidentifiable ingredients to be rejected; what pharmacies need to do

Pharmacy, Prescribing

BT202112

02/25/2021

FSSA announces the addition of COVID-19 vaccine administration billing for FQHC and RHC providers

FQHC, RHC

BT202111

02/25/2021

IHCP updates Preferred Diabetes Supply List

Pharmacy, Prescribing

BT202110

02/16/2021

IHCP clarifies drugs carved-out of managed care and PA criteria

Ordering, Prescribing or Referring (OPR); Pharmacy/Prescribing; Physician/Practitioner

BT202109

02/09/2021

Coverage and billing information for the 2021 annual HCPCS codes update

All

BT202108

02/09/2021

Certain denied claims may be resubmitted by March 31 for A&D HCBS case management services

Waiver

BT202107

02/09/2021

FSSA to resume standard rules for calculating patient and waiver liability March 1, 2021

All

BT202106

01/26/2021

IHCP to update rates for certain DME and medical supply items effective February 1, 2021

All, DME

BT202105

01/21/2021

Reimbursement updates for COVID vaccine administration

All, Pharmacy, Prescribing

BT202104

01/21/2021

IHCP clarifies coverage for substance use treatment

Behavioral Health

BT202103

01/21/2021

Advance care planning criteria will remain the same for calendar year 2021

Nursing Facility, Long-Term Care

BT202102

01/14/2021

IHCP update for COVID-19 vaccination pharmacy claims ordered and administered by pharmacists

Pharmacy, Prescribing

BT202101

01/12/2021

IHCP reimburses EMS provider agencies for COVID-19 vaccines administered by basic EMTs

All, Ambulance

BT2020132

12/31/2020

IHCP announces updates for ICD-10 codes, effective January 1, 2021

All

BT2020131

12/29/2020

IHCP to continue EVV post and pay

Home Health, Waiver

BT2020130

12/22/2020

FSSA announces CMS approval to BPHC service

Waiver

BT2020129

12/17/2020

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

All

BT2020128

12/17/2020

IHCP to update rates for certain DME and medical supply items

DME/HME

BT2020127

12/15/2020

IHCP to reimburse pharmacy providers for COVID-19 vaccine administration

Pharmacy, Prescribing

BT2020126

12/15/2020

IHCP clarifies enrollment and billing requirements for newly added behavioral health professionals

Behavioral Health

BT2020125

12/15/2020

2021 annual HCPCS update delayed

All

BT2020124

12/10/2020

FSSA selects managed care entities to serve Hoosier Care Connect members

All

BT2020123

12/10/2020

IHCP EVV implementation policy and FAQs provided as personal care service deadline nears

HCBS, Home Health

BT2020122

12/01/2020

IHCP announces procedure codes for newly enrolled behavioral health professionals

Behavioral Health

BT2020121

12/01/2020

Pharmacy updates approved by Drug Utilization Review Board November 2020

Pharmacy, Prescribing

BT2020120

12/01/2020

CMS announces new provider enrollment application fee for 2021

All

BT2020119

11/24/2020

Additional HCPCS 2020 code updates announced

All

BT2020118

11/12/2020

IHCP will reimburse EMS provider agencies for administration of vaccines

Paramedics, Advanced EMTs

BT2020117

11/10/2020

IHCP COVID-19 Response: IHCP announces FFS home health provider relief; apply by November 30

Home Health

BT2020116

11/05/2020

IHCP clarifies HIP Maternity benefits

All

BT2020115

10/27/2020

October 31 deadline set for nursing facility cost report and schedule submissions

Nursing Facility, Long-Term Care

BT2020114

10/27/2020

Pharmacy updates approved by Drug Utilization Review Board October 2020

Pharmacy, Prescribing

BT2020113

10/15/2020

IHCP announces review year 2021 CMS PERM resumes activity

All

BT2020112

10/13/2020

IHCP updates Preferred Diabetes Supply List

Pharmacy, Prescribing, DME/HME

BT2020111

10/06/2020

IHCP updates policy regarding treatment of spinal stenosis

Ambulatory Surgical Center, Clinic, Hospital, Physician/Practitioner

BT2020110

10/01/2020

October 2020 quarterly HCPCS code updates announced

All

BT2020109

09/29/2020

2020 IHCP Works Seminar to be held virtually October 13-15

All

BT2020108

09/29/2020

IHCP to enroll licensed behavioral health professionals

Mental Health, Psychiatric Residential Treatment Facility

BT2020107

09/29/2020

CMS releases new federal hospice rates for fiscal year 2021

Hospice

BT2020106

09/24/2020

IHCP COVID-19 Response: IHCP announces revised billing guidance for telemedicine services

All

BT2020105

09/24/2020

Pharmacy updates approved by Drug Utilization Review Board September 2020

Pharmacy, Prescribing

BT2020104

09/24/2020

Annual update of ICD-10 codes is effective October 1, 2020

All

BT2020103

09/17/2020

IHCP COVID-19 Response: NF temporary reimbursement rate extended and temporary resident add-on clarified

Nursing Facility

BT2020102

09/10/2020

IHCP announces corrections to DRG inpatient hospital reimbursement rates

Hospital, Rehabilitation Facility

BT2020101

09/01/2020

IHCP updates FQHC and RHC encounter codes

FQHC, RHC

BT2020100

09/01/2020

Alternate EVV vendors must begin integration by October 1, 2020

Home Health, HCBS Waiver

BT202099

09/01/2020

IHCP updates podiatry policy

All, Podiatrist

BT202098

09/01/2020

Pharmacy updates approved by Drug Utilization Review Board August 2020

Pharmacy, Prescribing

BT202097

09/01/2020

FSSA will amend BPHC program, pending CMS approval

Waiver

BT202096

08/27/2020

IHCP COVID-19 Response: IHCP clarifies policy on PA process for acute care hospital inpatient admissions

Hospital

BT202095

08/27/2020

IHCP announces requirement for pharmacies to use Quantity Prescribed (460-ET) field

Pharmacy, Prescribing

BT202094

08/25/2020

Enrollment requirement change for nursing home transportation providers

Transportation

BT202093

08/18/2020

Additional information provided for the July 2020 quarterly HCPCS codes updates

All

BT202092

07/23/2020

Pharmacy update approved by Drug Utilization Review Board July 2020

Pharmacy, Prescribing

BT202091

07/21/2020

IHCP updates policy for HIP members transitioning to FFS when moving into a nursing facility

Nursing Facility, Long-Term Care

BT202090

07/21/2020

IHCP announces updated changes to DRG grouper and cost-to-charge ratios

Hospital, Rehabilitation Facility

BT202089

07/21/2020

IHCP corrects rate reduction error on outpatient reimbursement

Hospital

BT202088

07/21/2020

IHCP COVID-19 Response: IHCP updates Pharmacy benefit PA expiration dates

Pharmacy, Prescribing

BT202087

07/16/2020

Enrollment as Transportation Network Company (TNC) will not require fingerprinting and background check

Transportation

BT202086

07/09/2020

IHCP COVID-19 Response: IHCP provides update on telemedicine policy

All, Therapist

BT202085

07/02/2020

IHCP announces update to transportation policy for minors

Transportation

BT202084

06/30/2020

July 2020 quarterly HCPCS code updates announced

All

BT202083

06/30/2020

FSSA changes rates and services for the FSW and CIH Waiver

Waiver

BT202082

06/30/2020

IHCP revises direct service provider requirement for IOT of members with SUD diagnosis

Mental Health, Therapist

BT202081

06/30/2020

New transportation provider specialty – Transportation Network Company (TNC), and how to enroll

Transportation

BT202080

06/30/2020

Portal enhanced for Family Member transportation provider enrollment

Transportation

BT202079

06/25/2020

IHCP revises Hospital Assessment Fee adjustment factors for outpatient and inpatient rates

Ambulatory Surgical Center, Clinic, Hospital

BT202078

06/25/2020

Pharmacy updates approved by Drug Utilization Review Board June 2020

Pharmacy, Prescribing

BT202077

06/25/2020

IHCP announces changes to DRG grouper and inpatient hospital reimbursement rates

Hospital, Rehabilitation Facility

BT202076

06/23/2020

FFS prior authorization telephone number change

All

BT202075

06/23/2020

IHCP COVID-19 Response: Certain respiratory inhalers resume pre-COVID-19 requirements

Pharmacy, Prescribing

BT202074

06/18/2020

IHCP COVID-19 Response: IHCP will update COVID-19 policy changes

All

BT202073

06/16/2020

FSSA clarifies amendment to the AMHH State Plan benefit

Waiver

BT202072

06/11/2020

IHCP COVID-19 Response: Managed care claim timely filing returns to 90 days

All

BT202071

06/11/2020

IHCP COVID-19 Response: COVID-19 policy FAQs as of June 11, 2020

All

BT202070

06/09/2020

IHCP pharmacy benefits resumes pre-COVID-19 process for early refill requests June 1, 2020

Pharmacy, Prescribing

BT202069

06/04/2020

Correction made to lifetime cap in A&D and TBI waiver services

Waiver

BT202068

05/28/2020

IHCP COVID-19 Response: Reimbursement updates for 86328 and 86769

Hospital, Laboratory

BT202067

05/28/2020

IHCP COVID-19 Response: IHCP publishes CMS revisions to transportation modifiers

Transportation

BT202066

05/28/2020

IHCP COVID-19 Response: BDDS modifies therapeutic leave for ICF/IID services

Waiver

BT202065

05/28/2020

Participant-directed attendant care and home care services available for A&D Waiver July 1, 2020

Waiver

BT202064

05/26/2020

IHCP COVID-19 Response: Newly released code added and coverage updated for Medicare crossover claims

All

BT202063

05/19/2020

IHCP provides billing guidance to EMS provider agencies for naloxone administration

Emergency Services, Ambulance

BT202062

05/19/2020

IHCP COVID-19 Response: IHCP issues summary of recently released COVID-19-related codes

All

BT202061

05/14/2020

IHCP COVID-19 Response: Additional COVID-19-related HCPCS and reimbursement updates made

All

BT202060

05/07/2020

IHCP announces EVV policy updates

Home Health, HCBS

BT202059

05/07/2020

IHCP announces changes to DRG grouper

Hospital, Rehabilitation Facility

BT202058

04/30/2020

IHCP will reimburse EMS provider agencies for administration of naloxone

EMS

BT202057

04/28/2020

IHCP COVID-19 Response: Additional HCPCS April 2020 quarterly code updates announced

All

BT202056

04/28/2020

IHCP COVID-19 Response: IHCP adds coverage of certain services for Medicare crossover claims

All

BT202055

04/28/2020

IHCP COVID-19 Response: Temporary changes allowed for signature requirements

All

BT202054

04/28/2020

IHCP COVID-19 Response: IHCP announces temporary provider enrollment recertification change

All

BT202053

04/23/2020

IHCP COVID-19 Response: IHCP allows EMS providers to receive minimum BLS reimbursement

Ambulance

BT202052

04/23/2020

IHCP COVID-19 Response: Ambulance providers to be reimbursed for response and treatment, no transport

Ambulance

BT202051

04/23/2020

Virtual 2020 IHCP Roadshow presentations now available, Q&A webinars the week of April 27, 2020

All

BT202050

04/23/2020

Copays no longer required for tobacco cessation drugs

Pharmacy, Prescribing

BT202049

04/21/2020

IHCP COVID-19 Response: Telemedicine FAQs as of April 21

All

BT202048

04/21/2020

IHCP COVID-19 Response: IHCP provides coding guidance for COVID-19

All

BT202047

04/21/2020

IHCP COVID-19 Response: IHCP revises managed care health plan PA policies for SNF admissions

Skilled Nursing Facility

BT202046

04/21/2020

IHCP COVID-19 Response: IHCP temporarily revises PA policy for LTAC and AIR facility admissions

Nursing Facility/Long-Term Care

BT202045

04/16/2020

IHCP COVID-19 Response: COVID-19 policy FAQs as of April 16

All

BT202044

04/16/2020

IHCP COVID-19 Response: IHCP makes updates to pharmacy benefits

Pharmacy, Prescribing

BT202043

04/14/2020

IHCP COVID-19 Response: Diagnosis code Z03.818 added to Emergency Department Autopay List

All

BT202042

04/09/2020

IHCP COVID-19 Response: IHCP revises policies for certain behavioral health services

Behavioral Health

BT202041

04/09/2020

Waiver attendant care providers get extension for transporting members to medical appointments

Waiver

BT202040

04/08/2020

IHCP COVID-19 Response: IHCP revises home health prior authorization and telemedicine policies

Home Health

BT202039

04/07/2020

IHCP COVID-19 Response: IHCP announces additional temporary changes for provider enrollment

All

BT202038

04/07/2020

IHCP COVID-19 Response: Additional HCPCS code updates announced

All

BT202037

04/07/2020

IHCP COVID-19 Response: Facility fees, modifier GT usage, and HCBS clarified for telemedicine billing

All

BT202036

04/07/2020

IHCP COVID-19 Response: IHCP extends timely filing limit on managed care claims

All

BT202035

04/02/2020

IHCP COVID-19 Response: IHCP revises policy for in-state ground transportation

Transportation

BT202034

04/02/2020

IHCP COVID-19 Response: IHCP responds to telemedicine FAQs as of April 1, 2020

All

BT202033

04/02/2020

IHCP COVID-19 Response: IHCP revises Medicaid policies

All

BT202032

04/02/2020

Hoosier Healthwise brand gets new look

All

BT202031

03/31/2020

IHCP temporarily removes prior authorization for certain DME or HME supplies and services

DME/HME

BT202030

03/31/2020

IHCP temporarily revises PA process for acute care hospital inpatient admissions

All

BT202029

03/31/2020

IHCP announces temporary changes to provider enrollment

All

BT202028

03/31/2020

CMS releases new ICD-10 diagnosis codes; IHCP adds codes to Emergency Department Autopay List

All, Physician/Practitioner

BT202027

03/31/2020

April 2020 quarterly HCPCS code updates announced

All

BT202026

03/24/2020

New transportation provider specialty to include nursing homes as transportation providers

Transportation

BT202025

03/24/2020

Certain denied claims may be resubmitted by May 31 for A&D HCBS case management services

Waiver

BT202024

03/24/2020

IHCP removes hospital lock-in requirements from Right Choices Program

Hospital

BT202023

03/24/2020

IHCP updates ACP criteria for nursing facilities

Nursing Facility/Long-Term Care

BT202022

03/19/2020

IHCP issues telemedicine billing guidance for providers during COVID-19 outbreak

All

BT202021

03/19/2020

IHCP changes pharmacy benefits and Emergency Department Autopay List in response to COVID-19

Emergency Services, Managed Care, Pharmacy/Prescribing

BT202020

03/17/2020

FSSA will change rates and services for the FSW and CIH Waiver, pending CMS approval

Waiver

BT202019

03/10/2020

IHCP revises policy regarding certain transplant procedures

Physician/Practitioner

BT202018

03/10/2020

IHCP clarifies billing for HIP chiropractic services

Chiropractor

BT202017

03/10/2020

OBSOLETE

 

BT202016

03/05/2020

IHCP updates Preferred Diabetes Supply List

Pharmacy/Prescribing, DME/HME

BT202015

03/03/2020

IHCP to implement third-party liability cost avoidance on prenatal care claims

All

BT202014

02/27/2020

Pharmacy updates approved by Drug Utilization Review Board February 2020

Pharmacy, Prescribing

BT202013

02/27/2020

FSSA announces amendment to the Adult Mental Health Habilitation program

AMHH, Mental Health

BT202012

02/25/2020

IHCP revises policy for augmentative and alternative communication devices

DME/HME

BT202011

02/18/2020

Additional information related to the 2020 annual HCPCS codes update

All

BT202010

02/11/2020

IHCP expands coverage for genetic testing for breast cancer recurrence

Physician/Practitioner

BT202009

01/30/2020

IHCP changes requirements for MCE emergency services claim processing

Managed Care, Emergency

BT202008

01/28/2020

Pharmacy update approved by Drug Utilization Review Board January 2020

Pharmacy, Prescribing

BT202007

01/23/2020

Changes to location and time for January 24 provider meeting

All

BT202006

01/23/2020

FSSA changes rate and methodology for A&D and TBI waiver services

Waiver

BT202005

01/21/2020

FSSA announces amendment to the CMHW Program

Mental Health

BT202004

01/16/2020

IHCP announces new IHCP Roadshow in 2020

All

BT202003

01/09/2020

IHCP gains federal approval to reimburse for acute SMI stays in IMDs

Psych Residential Treatment Facility

BT202002

01/07/2020

IHCP revises policy for radiology services

Radiology

BT202001

01/07/2020

Pharmacy update approved by Drug Utilization Review Board December 2019

Pharmacy, Prescriber

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