MedicaidBilling CodesMedium impact
BT202160: CMS clarifies that MCEs can continue to bypass NCCI edit causing NOP claims to deny
Indiana Medicaid (IHCP)·IN · OB-GYN·Provider Bulletin
Effective date
Jul 22, 2021
We identified it
Jun 19, 2026
Summary
CMS has clarified that Indiana Medicaid managed care entities can continue to bypass NCCI edits for Notification of Pregnancy (NOP) claims involving CPT 99354 with modifier TH when billed with E/M services. This reverses previous guidance that would have caused these claims to be denied.
Action Required
Immediately: Billing team can resume submitting NOP forms through the IHCP Provider Healthcare Portal and continue billing CPT 99354 with modifier TH alongside E/M services for obstetrical visits. Update billing staff that these claims will no longer be denied due to NCCI edits for Indiana Medicaid managed care plans.