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MedicaidBilling CodesMedium impact

BT202481: IHCP changes billing instructions for Prevocational services under FSW and CIH Waiver

Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Occupational Therapy·Claims & Billing
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) is changing billing codes and modifiers for Prevocational services under FSW and CIH Waivers. New procedure code combinations with specific participant-to-provider ratios take effect July 1, 2024, while old codes are discontinued June 30, 2024.

Action Required

Action needed
By June 30, 2024: Stop using old T2015 modifier combinations (U2, U4, U6, UA, UB, UC, UD, U9 with UG/UF). By July 1, 2024: Update billing system to use new T2015 modifier combinations (U1/UF, U2/UG, U3/UF, U4/UG, U8/UF, U9/UG) that specify facility vs community-based settings and participant ratios. Ensure billing matches approved service authorization or claims will be denied. Update rates: $10.81/hour for 2:1-4:1 ratios, $5.66/hour for 6:1-10:1 ratios, $3.73/hour for 12:1-16:1 ratios.

Affected Billing Codes

T2015