MedicaidBilling CodesMedium impact
BT202116: Additional billing instructions presented for EMS treat-no-transport and naloxone administration
Indiana Medicaid (IHCP)·IN · Emergency Medicine·Claims & Billing
Effective date
Feb 25, 2021
We identified it
Jun 19, 2026
Summary
Indiana Medicaid will now systematically deny claims when EMS treat-no-transport code A0998 is billed on the same claim with emergency transportation codes (A0427/A0429) or naloxone administration (96372 U1/U2) for the same date of service. Separate encounters require modifier XE or 59 to indicate distinct services.
Action Required
Immediately: EMS billing teams must update billing software to prevent A0998 from being billed on same claim as A0427, A0429, or 96372 U1/U2 for same date of service. Add modifier XE or 59 when separate encounters occurred. Train staff on new EOB 6539 denial code. Claims will be systematically denied without proper modifiers.