MedicaidBilling CodesHigh impact
[Indiana] Community Behavioral Health Clinics Services Billing Reminder
CareSource·IN · Psychiatry·Claims & Billing
Effective date
Jan 1, 2025
We identified it
May 9, 2026
Summary
Effective January 1, 2025, Certified Community Behavioral Health Clinics (CCBHC) services in Indiana are carved out of CareSource managed care and reimbursed as fee-for-service through Gainwell. CCBHCs must now submit claims with specific coding requirements: HCPCS code T1040 (one unit per claim), at least one triggerable CCBHC encounter code, the Q2 modifier (or V2 for Designated Collaborating Organizations), and all other services provided on the same date. Prior authorizations are processed by Acentra Health.
Action Required
By January 1, 2025: Billing team must reconfigure billing system to route all CCBHC claims to Gainwell (not CareSource managed care). Update claim templates to require: (1) exactly one unit of HCPCS code T1040, (2) at least one triggerable procedure code from the valid CCBHC encounter code list, (3) Q2 modifier on all encounter services (V2 modifier if services provided by Designated Collaborating Organization), and (4) all other services provided on the same date of service. Provider staff must use the NPI assigned to CCBHC with provider specialty 623. Submit all prior authorization requests to Acentra Health instead of CareSource. Route claims for dates of service on or after January 1, 2025 to Gainwell. Failure to include required coding elements and modifiers will result in claim denials. Reference IHCP bulletins BT2025136, BT202592, BT202533, BT2024210, and BT2024193 for detailed billing guidance. Contact Indiana_BH@CareSource.com with questions.