Who is affected by this change?

This affects Indiana Medicaid (IHCP) Nephrology providers in IN on Medicaid plans.

When does this change take effect?

This change is effective Jan 8, 2026.

Which billing codes are affected?

The following codes are affected: J0605, J0609, J0911.

Back to dashboard

MedicaidBilling CodesMedium impact

BT202604: Procedure codes added to renal dialysis composite rate

Indiana Medicaid (IHCP)·IN · Nephrology·Claims & Billing

Effective date

Jan 8, 2026

We identified it

Jun 18, 2026

Days to comply

—

Summary

Three HCPCS codes (J0605, J0609, J0911) for ESRD drugs are now included in the renal dialysis composite rate and cannot be billed separately for dialysis patients. This change is effective immediately and retroactive to the original CMS effective dates for each code.

Action Required

Action needed

Immediately: Billing team must update workflows to stop billing codes J0605, J0609, and J0911 separately for ESRD dialysis patients - these are now bundled into the composite rate. Review and update billing software rules to prevent separate billing when these codes are used on the same date of service as renal dialysis composite-rate revenue codes. Monitor remittance advices starting Jan 14, 2026 for reprocessed claims with ICNs beginning with 52.

Affected Billing Codes

J0605

J0609

J0911

Related policy hubs

Indiana Medicaid (IHCP) policies IN policy changes Nephrology Code J0605 Code J0609 Code J0911