MedicaidCoverageMedium impact
BT2025184: Additional biomarker testing codes covered for DOS on or after Jan. 12, 2026
Indiana Medicaid (IHCP)·IN · Oncology, Pathology·Provider Bulletin
Effective date
Jan 12, 2026
We identified it
Jun 18, 2026
Summary
Indiana Health Coverage Programs (IHCP) is adding coverage for three new biomarker testing codes effective January 12, 2026. All three new codes (0493U, 81459, 81463) require prior authorization and are covered under Traditional Medicaid and full Indiana Medicaid State Plan benefits.
Action Required
Before January 12, 2026: Billing team must update systems to recognize new covered biomarker testing codes 0493U, 81459, and 81463 for Indiana Medicaid patients. Configure prior authorization requirements for all three codes. Update encounter forms to remind providers that PA is required. For FFS claims, contact Acentra Health at 866-725-9991 for PA questions. For managed care, contact the specific MCE.