MedicaidCoverageMedium impact
BT2024118: IHCP removes coverage for procedure code J8610
Indiana Medicaid (IHCP)·IN · Rheumatology, Oncology, Dermatology·Claims & Billing
Effective date
Aug 30, 2024
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) is removing coverage for procedure code J8610 (oral methotrexate 2.5 mg) from the medical benefit effective August 30, 2024. The medication will still be covered through the pharmacy benefit instead.
Action Required
Before August 30, 2024: Billing team must stop submitting claims for HCPCS code J8610 (oral methotrexate 2.5 mg) to IHCP medical benefit. Update billing system to flag this code as non-covered. Inform providers that oral methotrexate must be prescribed through pharmacy benefit instead. Claims submitted to medical benefit after this date will be denied.