MedicaidReimbursementHigh impact
BT2023169: IHCP announces fee schedule for ABA therapy services, effective Jan. 1, 2024
Indiana Medicaid (IHCP)·IN · Psychiatry, Pediatrics·Claims & Billing
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is implementing a new fee schedule for ABA therapy services effective January 1, 2024, with new procedure code-modifier combinations required for proper reimbursement. All ABA therapy claims with dates of service on or after January 1, 2024 must use the specified modifier combinations (U1, U2, U3) based on the provider's credential level.
Action Required
By January 1, 2024: Billing team must update system to require specific modifiers for all ABA therapy codes: U1 for RBT services, U2 for BCaBA services, U3 for BCBA/BCBA-D/physician services. Update billing software to include new fee schedule rates. Train staff on proper modifier selection based on provider credentials. Claims without correct modifiers will not receive appropriate reimbursement under the minimum fee schedule.