MedicaidPrior AuthMedium impact
BT2024145: IHCP removes PA from Pylarify (A9595)
Indiana Medicaid (IHCP)·IN · Nuclear Medicine, Oncology, Urology·Provider Bulletin
Effective date
Dec 11, 2023
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) has removed the prior authorization requirement for Pylarify (HCPCS code A9595), effective December 11, 2023. Providers can retroactively submit previously denied claims within specific timeframes (90 days for managed care, 180 days for fee-for-service).
Action Required
By December 18, 2024 (90 days from bulletin): Managed care billing team should resubmit any previously denied Pylarify (A9595) claims that were denied for lack of prior authorization, including a copy of this bulletin with submissions. By March 18, 2025 (180 days from bulletin): Fee-for-service billing team should resubmit any previously denied A9595 claims with bulletin attached.