[Indiana] SUD Residential Treatment Providers and Follow-up After Hospitalization

By May 28, 2025: SUD residential treatment providers must audit current practices to ensure compliance with evaluation timing requirements. Verify that: (1) all initial evaluations for post-hospitalization members are completed in-person within 7 days; (2) follow-up evaluations occur at least every 7 days during residential stay; (3) evaluations are conducted or supervised by physicians, PAs, or APRNs; (4) telemedicine is used only when necessary for follow-up visits, not initial evaluations. Billing team must review billing practices for H2034 and H0010 claims to ensure no duplicate billing of services included in per diem; any services rendered outside the per diem scope must be billed under separate, appropriate IHCP-enrolled provider types and specialties. Establish protocol with Care Management teams regarding member information sharing compliance with HIPAA and IC 16-39-2-6(a). Obtain Member Consent and HIPAA Authorization Form for SUD records disclosures when required. Update staff training on documentation requirements to support compliance verification. Non-compliance may result in claim denials for unbilled additional services or audit findings regarding care coordination failures.