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MedicaidBilling CodesHigh impact

BT202520: Updated coverage and billing information for the 2025 annual HCPCS code update

Indiana Medicaid (IHCP)·IN · Plastic Surgery, Orthopedics, Oncology +3 more·Claims & Billing
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) released the 2025 annual HCPCS code update effective January 1, 2025, adding new CPT/HCPCS codes for skin grafts, joint procedures, CAR-T therapy, and abdominal procedures. The bulletin corrects telehealth modifier 93 allowability for procedure codes 98000-98007 from 'Yes' to 'No' and provides extended filing deadlines for covered codes.

Action Required

Action needed
Immediately: Update billing system with 2025 HCPCS codes effective January 1, 2025. Add prior authorization requirements for CPT codes 25448, 38225, 38226, 38227, and 38228. Remove modifier 93 (audio-only) allowability for codes 98000-98007. For covered new codes, claims can be submitted up to 90 days from February 6, 2025 for managed care or 180 days for fee-for-service with bulletin attachment. Update fee schedules from in.gov/medicaid/providers when posted.

Affected Billing Codes

15011
15012
15013
15014
15015
15016
15017
15018
25448
38225
38226
38227
38228
49186
49187
49188
49189
49190
98000
98001
98002
98003
98004
98005
98006
98007