MedicaidCoverageMedium impact
BT2024150: IHCP adds outpatient reimbursement for certain laboratory service codes
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Apr 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) now allows separate outpatient reimbursement for 8 specific laboratory CPT codes, effective retroactively from April 1, 2022. Claims that previously denied with EOB codes 4801 or 4804 for these lab services will be automatically reprocessed starting October 30, 2024.
Action Required
By March 25, 2025: Billing team should review remittance advices beginning October 30, 2024 for reprocessed claims with ICNs starting with '80'. For any affected claims with DOS on or after April 1, 2022 that denied with EOB codes 4801 or 4804, resubmit within 180 days (by March 25, 2025) and attach a copy of this bulletin if beyond original filing limit. Update billing system to reflect these 8 lab codes are now separately reimbursable in outpatient settings for IHCP.