Who is affected by this change?

This affects Indiana Medicaid (IHCP) Critical Care, Pulmonology, Infectious Disease providers in IN on Medicaid plans.

When does this change take effect?

This change is effective Jun 24, 2021.

Which billing codes are affected?

The following codes are affected: M0249, M0250, Q0249.

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MedicaidBilling CodesMedium impact

BT202170: IHCP covers additional COVID-19 treatment codes M0249, M0250 and Q0249

Indiana Medicaid (IHCP)·IN · Critical Care, Pulmonology, Infectious Disease·Provider Bulletin

Effective date

Jun 24, 2021

We identified it

Jun 19, 2026

Days to comply

—

Summary

IHCP (Indiana Medicaid) now covers three new COVID-19 tocilizumab treatment codes M0249, M0250, and Q0249 for hospitalized patients age 2+ requiring oxygen support or mechanical ventilation. No prior authorization required, with specific reimbursement rates for professional and outpatient claims.

Action Required

Action needed

Immediately: Billing team must add new COVID-19 tocilizumab codes M0249, M0250, and Q0249 to billing system with specified reimbursement rates ($403.66/$450.50 for M0249/M0250, $6.05 for Q0249). Update system to require NDC for Q0249 only and allow revenue code 636 for outpatient billing. Configure age restriction of 2+ years for all three codes.

Affected Billing Codes

M0249

M0250

Q0249

Related policy hubs

Indiana Medicaid (IHCP) policies IN policy changes Critical Care Pulmonology Infectious Disease Code M0249 Code M0250 Code Q0249