MedicaidPrior AuthHigh impact
BT202180: IHCP COVID-19 Response: PA changes temporarily reinstated for some DME/HME supplies and services
Indiana Medicaid (IHCP)·IN · Pulmonology, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Sep 8, 2021
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) is temporarily removing prior authorization requirements for respiratory DME/HME supplies and services, plus repairs/replacements of existing DME/HME equipment, effective September 8, 2021, in response to increased COVID-19 cases. This streamlines billing for oxygen equipment, nebulizers, and other respiratory supplies.
Action Required
Immediately: Update billing system to remove prior authorization requirements for the listed respiratory DME/HME codes for Indiana Medicaid patients. Train billing staff to process these claims without PA verification. For repairs/replacements, use modifiers RA (replacement) or RB (part replacement) and bill labor with K0739. Maintain documentation of medical necessity for all repairs/replacements as PA is waived but documentation requirements remain.