MedicaidBilling CodesMedium impact
BT202399: IHCP clarifies billing for medroxyprogesterone acetate injection (HCPCS code J1050)
Indiana Medicaid (IHCP)·IN · OB-GYN, Family Medicine, Internal Medicine·Claims & Billing
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
IHCP changed billing for Depo-SubQ Provera injections from HCPCS code J1050 to J3490 due to CMS pricing methodology changes. Claims previously denied under J1050 should be resubmitted using J3490 with specific NDC and unit requirements.
Action Required
Within 90 days for managed care claims or 180 days for FFS claims: Billing team must resubmit all denied Depo-SubQ Provera claims using HCPCS code J3490 instead of J1050. Use NDC 00009-4709-13 with 0.65 mL units and UOM as mL. Attach bulletin BT202399 as timely filing waiver for previously denied claims. Update billing system to use J3490 for all future Depo-SubQ Provera 104 mg/0.65 mL claims.