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BT202570: IHCP announces additional COVID-19 coverage changes due to American Rescue Plan expiration

Indiana Medicaid (IHCP)·IN · Family Medicine, OB-GYN, Emergency Medicine +1 more·Medical Policy
Effective date
Oct 1, 2024
We identified it
Jun 18, 2026
Days to comply

Summary

IHCP is ending temporary COVID-19 coverage expansions for Family Planning Eligibility Program members due to American Rescue Plan expiration. Emergency department visits, home visits, chest X-rays, and other COVID-related services are no longer covered, and office visits now require the FP modifier to be covered.

Action Required

Action needed
Immediately: Billing team must update system rules to deny claims for Family Planning Eligibility Program members using the specified procedure and diagnosis codes for dates of service on or after October 1, 2024. Add FP modifier requirement for office visit codes 99202-99215 for these members. Review and reprocess any claims from October 2024 forward that may have been incorrectly paid. Contact Gainwell Technologies at 800-457-4584 with questions.

Affected Billing Codes

71046
94760
99281
99282
99283
99284
99285
99341
99342
99344
99345
99347
99348
99349
99350
M0201
99202
99203
99204
99205
99211
99212
99213
99214
99215
Z03.818
Z11.52
Z11.59
Z20.822
Z20.828
Z23