MedicaidCoverageHigh impact
BT202124: IHCP clarifies rental periods of DME capped rental items submitted on or after April 1, 2021
Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Physical Therapy·Provider Bulletin
Effective date
Apr 1, 2021
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) reduced DME rental caps from 15 months to 6 or 10 months for select procedure codes, effective for claims submitted on/after April 1, 2021 with dates of service on/after February 1, 2021. Claims exceeding the new rental periods will be denied with specific EOBs.
Action Required
By April 1, 2021: Billing team must update DME rental tracking to monitor new 6-month and 10-month caps instead of 15-month caps for affected procedure codes. Reference IHCP Bulletin BT202106 for complete list of affected codes. Update billing system to track rental units and prevent submission of claims exceeding caps. Monitor for denial codes EOB 6186 (6-month cap), EOB 6187 (10-month cap), and EOB 6080 (15-month cap). Claims exceeding caps will be automatically denied even with prior authorization.