MedicaidCoverageMedium impact
BT2022115: IHCP to add coverage for nucleic acid amplification tests for bacterial vaginitis
Indiana Medicaid (IHCP)·IN · OB-GYN, Family Medicine, Internal Medicine·Medical Policy
Effective date
Jan 16, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) will begin covering CPT code 81513 for nucleic acid amplification tests to detect bacterial vaginitis effective January 16, 2023, with a maximum reimbursement of $142.63 and no prior authorization required. This applies to Traditional Medicaid and all managed care programs including HIP, Hoosier Care Connect, and Hoosier Healthwise.
Action Required
By January 16, 2023: Billing team must update system to allow billing of CPT code 81513 for bacterial vaginitis nucleic acid amplification tests for Indiana Medicaid patients. Set maximum reimbursement rate at $142.63 and configure system to not require prior authorization. Update encounter forms to include this new covered service for applicable IHCP programs.