MedicaidPrior AuthMedium impact
BT202260: IHCP temporarily suspends MCE PA requirements for respiratory assist devices
Indiana Medicaid (IHCP)·IN · Pulmonology, Sleep Medicine, General Practice·Provider Bulletin
Effective date
Aug 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid is temporarily suspending prior authorization requirements for continued use of CPAP and BiPAP devices from August 1, 2022 through January 31, 2023, due to the Philips recall. This only applies to continuation of existing devices, not new device orders.
Action Required
Immediately: Billing team should update prior authorization workflows for Indiana Medicaid managed care plans to remove PA requirements for codes E0601, E0470, E0471, and E0472 for continuation services through January 31, 2023. Continue to obtain PA for new device orders and ensure providers document medical necessity and patient compliance acknowledgment in medical records.