MedicaidAdministrativeMedium impact
BT202511: IHCP updates Notification of Pregnancy billing guidelines for FQHCs and RHCs
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, OB-GYN +1 more·Claims & Billing
Effective date
Jan 30, 2025
We identified it
Jun 19, 2026
Summary
IHCP updated billing guidelines for Notification of Pregnancy (NOP) claims for FQHCs and RHCs. Effective immediately, these providers must submit NOP claims on the same encounter as other services, not separately as previously required.
Action Required
Immediately: FQHCs and RHCs must begin submitting NOP claims (G9997 TH modifier) on the same claim as other encounters for the visit. Stop submitting separate NOP claims as of Jan 30, 2025. Update billing system workflows to include T1015 code with NOP encounters. Gainwell will automatically adjust underpaid claims from Jan 1, 2023 forward.