Who is affected by this change?

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

When does this change take effect?

This change is effective Jan 1, 2026.

Which billing codes are affected?

The following codes are affected: 36415, 36416.

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MedicaidReimbursementMedium impact

BT2025160: IHCP updating outpatient reimbursement rates for procedure codes 36415 and 36416

Indiana Medicaid (IHCP)·IN·Claims & Billing

Effective date

Jan 1, 2026

We identified it

Jun 18, 2026

Days to comply

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Summary

Indiana Health Coverage Programs (IHCP) is updating outpatient reimbursement rates for blood collection procedures effective January 1, 2026. CPT 36415 (needle insertion into vein for blood collection) will reimburse at $9.09 and CPT 36416 (skin puncture for blood collection) will reimburse at $3.77.

Action Required

Action needed

Before January 1, 2026: Billing team must update fee schedules and billing system with new IHCP reimbursement rates - CPT 36415 to $9.09 and CPT 36416 to $3.77. Verify updated rates are published on the IHCP Fee Schedules webpage at in.gov/medicaid/providers.

Affected Billing Codes

36415

36416

Related policy hubs

Indiana Medicaid (IHCP) policies IN policy changes Code 36415 Code 36416