MedicaidReimbursementMedium impact
BT2024174: IHCP updates reimbursement for certain dental codes
Indiana Medicaid (IHCP)·IN · Dentistry, Oral & Maxillofacial Surgery·Claims & Billing
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
IHCP corrected pricing for 5 dental codes (D1301, D2976, D6089, D7284, D9954) that were previously priced incorrectly, changing them from RBRVS to manually priced effective January 1, 2024. IHCP will automatically reprocess affected claims starting December 4, 2024, and prior authorization is now required for code D7284.
Action Required
By December 4, 2024: Dental billing staff should monitor remittance advices for reprocessed claims with ICNs beginning with 80. Immediately: Update billing system to require prior authorization for D7284 (excisional biopsy of minor salivary glands). For any claims not automatically adjusted: Submit within 90 days (managed care) or 180 days (FFS) of October 31, 2024, including a copy of this bulletin to satisfy timely filing requirements.