MedicaidAdministrativeMedium impact
[Indiana] February 2026 Policy Updates
CareSource·IN · Pain Management·Medical Policy
Effective date
Apr 1, 2026
We identified it
May 9, 2026
Summary
CareSource Indiana Medicaid is releasing six policy updates effective April 1, 2026 (one effective March 1, 2026), including new policies on Medical Necessity Determinations and Coding Guidelines, plus revisions to Clinical Trial Coverage, Pain Management Providers, Three-Day Window Payment, and Claims Editing and Review. Your billing team must review each policy on the CareSource website and implement corresponding workflow changes before the effective dates.
Action Required
Before April 1, 2026: Billing team must access CareSource.com > Providers > Tools & Resources > Provider Policies, select Indiana Medicaid, and review all six policies in detail (Clinical Trial Coverage MM-0797, Pain Management Providers AD-1099, Medical Necessity Determinations AD-1618, Three-Day Window Payment AD-1000, Claims Editing and Review AD-1183, and Coding Guidelines PY-1717). Document any changes to billing workflows, prior authorization requirements, coding practices, and claims editing rules. Before March 1, 2026: Separately review the Clinical Trial Coverage MM-0797 revision which has an earlier effective date. Update billing system rules, encounter forms, and staff training materials accordingly. Identify which policies trigger changes to your specific workflows and assign responsibility for implementation to relevant team members.