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BT202411: IHCP updates Structured Family Caregiving claim billing and processing instructions

Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Mar 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP (Indiana Medicaid) now requires provider name and relationship documentation for Structured Family Caregiving claims and prohibits billing multiple concurrent services in the same month. Claims missing required documentation or violating service restrictions will be denied or recouped.

Action Required

Action needed
By March 1, 2024: Billing team must update all Attendant Care and Structured Family Caregiving claims to include NAME: (provider name) and REL: (relationship) in field 19 for paper claims or Additional Information notes for electronic submissions. Implement system edits to prevent billing S5125, S5130, S5150, or T1005 in same calendar month as Structured Family Caregiving. Claims without proper documentation will be denied and concurrent services will be recouped retroactively.

Affected Billing Codes

S5125
S5130
S5150
T1005