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BT202018: IHCP clarifies billing for HIP chiropractic services

Indiana Medicaid (IHCP)·IN · Chiropractic, Physical Therapy·Claims & Billing
Effective date
Mar 10, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP has clarified billing limits and coverage for chiropractic services across HIP plans. HIP Basic excludes chiropractic manipulations but covers 60 units of therapy services; HIP Plus allows 6 manipulations plus 75 therapy units; HIP State Plan provides 50 total chiropractic units including up to 5 office visits.

Action Required

Action needed
Immediately: Billing team must update system to apply correct annual limits for HIP members: HIP Basic (60 therapy units, no manipulations), HIP Plus (6 manipulations + 75 therapy units), HIP State Plan (50 total chiropractic units, max 5 office visits). Configure billing software to track units separately by plan type and exclude radiology, lab, diabetic education, and community health worker services from limits.

Affected Billing Codes

95831
95832
97012
97014
97016
97018
97022
97024
97026
97028
97032
97033
97034
97035
97036
97039
97110
97112
97113
97116
97124
97139
97140
98940
98941
98942
98943
99201
99202
99203
99211
99212
99213