MedicaidCoverageMedium impact
BT2024185: IHCP announces coverage of additional biomarker testing codes
Indiana Medicaid (IHCP)·IN · Oncology, Hematology, OB-GYN +1 more·Medical Policy
Effective date
Nov 1, 2024
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Health Coverage Programs) has added coverage for 5 additional biomarker testing codes effective retroactively from November 1, 2024. All codes require prior authorization and are covered under both managed care and fee-for-service delivery systems.
Action Required
Immediately: Billing team must update system to recognize newly covered biomarker testing codes 81422, 81450, 0345U, 0411U, and 0340U as covered services for Indiana Medicaid patients with dates of service on or after November 1, 2024. Configure system to require prior authorization for all these codes. Update encounter forms to remind providers that PA is required. Contact appropriate entities for prior auth: Acentra Health (866-725-9991) for fee-for-service or the specific MCE for managed care patients.