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MedicaidCoverageLow impact

BT2024115: IHCP removes coverage for procedure code J0275

Indiana Medicaid (IHCP)·IN · Urology·Claims & Billing
Effective date
Aug 22, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP (Indiana Medicaid) will no longer cover HCPCS code J0275 (Alprostadil urethral suppository) effective August 22, 2024. This affects both fee-for-service and managed care Medicaid claims in Indiana.

Action Required

Action needed
Before August 22, 2024: Billing team must update system to mark HCPCS code J0275 as non-covered for Indiana Medicaid (IHCP) claims. Remove from encounter forms for IHCP patients. Claims submitted after this date will be denied.

Affected Billing Codes

J0275