MedicaidReimbursementMedium impact
BT2025114: IHCP corrects outpatient reimbursement issue for procedure code 96127
Indiana Medicaid (IHCP)·IN · Psychiatry, Family Medicine, Pediatrics +1 more·Claims & Billing
Effective date
Aug 5, 2025
We identified it
Jun 18, 2026
Summary
IHCP identified and corrected a billing system issue that was incorrectly denying outpatient claims for CPT 96127 (brief behavioral assessment). The system will automatically reprocess denied claims from August 2023 forward, with adjusted payments appearing on remittance advices starting September 3, 2025.
Action Required
Monitor remittance advices starting September 3, 2025 for automatically reprocessed CPT 96127 claims (ICNs beginning with 52 or 80). For any missed claims with dates of service August 5, 2023 or later, resubmit within 180 days of August 5, 2025, attaching a copy of this bulletin if beyond original filing limits. Ensure CPT 96127 is billed with appropriate revenue code 918.