MedicaidReimbursementMedium impact
BT2025158: IHCP to move Baclofen (J0475) from manually priced to maximum fee pricing
Indiana Medicaid (IHCP)·IN · Neurology, PM&R (Physical Medicine & Rehab), Pain Management +1 more·Provider Bulletin
Effective date
Jul 1, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid (IHCP) is changing HCPCS code J0475 (baclofen injection, 10 mg) from manually priced to maximum fee pricing, effective retroactively from July 1, 2025. Claims will be mass adjusted with adjustments appearing on remittance advices dated December 17, 2025.
Action Required
By December 17, 2025: Billing team should monitor remittance advices for mass adjustments to J0475 claims with dates of service July 1, 2025 or later. Look for internal control numbers beginning with 52 indicating mass replacements. No immediate billing changes required as adjustments will be processed automatically.