MedicaidPrior AuthMedium impact
BT2023174: IHCP updates prior authorization requirements for select chiropractic services
Indiana Medicaid (IHCP)·IN · Chiropractic, Physical Therapy·Prior Authorization
Effective date
Jan 15, 2024
We identified it
Jun 19, 2026
Summary
Starting January 15, 2024, Indiana Medicaid (IHCP) will require prior authorization for 16 specific chiropractic therapy procedure codes including electrical stimulation, ultrasound, massage, and manual therapy techniques. This is in addition to existing limits of 50 total chiropractic units per member per calendar year.
Action Required
By January 15, 2024: Billing team must update system to require prior authorization for CPT codes 97012, 97014, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97113, 97124, 97139, and 97140 for Indiana Medicaid chiropractic patients. Contact Kepro Customer Service at 866-725-9991 for fee-for-service PA requirements or the specific MCE for managed care patients. Claims without required prior authorization will be denied.