MedicaidCoverageMedium impact
BT202526: IHCP adds coverage for iloprost (Q4074)
Indiana Medicaid (IHCP)·IN · Pulmonology, Critical Care·Medical Policy
Effective date
Feb 27, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers iloprost inhalation solution under HCPCS code Q4074, retroactive to February 27, 2023. Prior authorization will be required for dates of service on or after March 27, 2025, and all claims must include the National Drug Code (NDC).
Action Required
Immediately: Billing team can now submit claims for HCPCS Q4074 (iloprost inhalation solution) for IHCP/Medicaid patients with dates of service from Feb 27, 2023 forward - all claims must include NDC and use revenue code 636 for institutional outpatient claims. By March 27, 2025: Update system to require prior authorization for Q4074 using Pulmonary Antihypertensives PA Criteria. Resubmit any previously denied Q4074 claims within 90 days (managed care) or 180 days (fee-for-service) including copy of bulletin.