MedicaidBilling CodesMedium impact
BT202104: IHCP clarifies coverage for substance use treatment
Indiana Medicaid (IHCP)·IN · Psychiatry·Medical Policy
Effective date
Jan 21, 2021
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) clarifies that substance use disorder (SUD) residential facilities cannot bill for methadone treatment and must use separate provider enrollments for buprenorphine/naltrexone MAT services. Only designated Opioid Treatment Programs can bill for methadone.
Action Required
Immediately: Billing teams at SUD residential facilities (provider specialty 836) must stop billing for methadone treatment under this provider type. Ensure methadone services are billed through separately enrolled Opioid Treatment Program (provider specialty 835). For buprenorphine/naltrexone MAT, qualified prescribers must bill under appropriate non-SUD provider specialties. Update billing system rules to prevent incorrect provider specialty usage for these medications.