MedicaidBilling CodesMedium impact
BT202158: IHCP updates Outpatient Fee Schedule
Indiana Medicaid (IHCP)·IN · Radiology, Psychiatry, Oncology·Claims & Billing
Effective date
Jul 20, 2021
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) has updated their Outpatient Fee Schedule to correct discrepancies, removing duplicate codes, adding missing covered and non-covered codes, removing end-dated codes, and eliminating CDT codes from institutional claims. Several codes now have specific pricing or prior authorization requirements.
Action Required
Immediately: Billing team must update system to require prior authorization for psychological testing codes 96112, 96130, 96132, 96136, 96138, and 96146. Remove behavioral intervention codes 97151-97158 from outpatient claim forms as they are not reimbursable on institutional claims. Update fee schedules with new pricing for BRCA genetic testing codes and breast MRI codes. Verify CDT dental codes are not being billed on UB-04 forms. Review and update all affected procedure codes in billing system per the new fee schedule.