MedicaidBilling CodesMedium impact
BT2025113: Separate reimbursement to be allowed for implantable DME code L8679 for outpatient surgeries
Indiana Medicaid (IHCP)·IN · Neurosurgery, Pain Management, Orthopedics·Claims & Billing
Effective date
Sep 5, 2025
We identified it
Jun 18, 2026
Summary
Starting September 5, 2025, Indiana Medicaid (IHCP) will allow separate reimbursement for implantable neurostimulator pulse generators (HCPCS L8679) when implanted in outpatient surgical settings. The device must be billed on a professional claim separate from the institutional claim for the implantation procedure.
Action Required
Before September 5, 2025: Billing team must update procedures to bill HCPCS code L8679 (implantable neurostimulator pulse generator) on separate professional claims (CMS-1500) rather than including on institutional outpatient claims for implantation procedures. Submit all fee-for-service prior authorization requests to Acentra Health (866-725-9991) and claims to Gainwell Technologies (800-457-4584). This applies only to outpatient surgical settings for Indiana Medicaid patients.