MedicaidAdministrativeMedium impact
[Indiana] Policy Updates August 2025
CareSource·IN·Medical Policy
Effective date
Oct 1, 2025
We identified it
May 9, 2026
Summary
CareSource Indiana Medicaid is implementing four policy updates effective October 1, 2025: revisions to Itemized Billing (AD-0865), Medical Record Documentation Standards (AD-0754), and Modifiers (PY-1347), plus a new policy on Urinalysis and Evaluation and Management Services (PY-1606). Billing teams must review each policy detail and update workflows, documentation requirements, billing codes, and prior authorization procedures accordingly.
Action Required
By September 15, 2025: Billing team must access CareSource.com > Providers > Tools & Resources > Provider Policies, select Indiana Medicaid, and download the full text of all four updated policies (AD-0865, AD-0754, PY-1347, PY-1606). Review each policy line-by-line and identify specific billing code changes, documentation requirements, modifier applications, and prior authorization triggers. By September 30, 2025: Update billing software, encounter templates, and provider education materials to reflect changes in itemized billing format, medical record documentation standards, modifier usage, and urinalysis/E&M service rules. Communicate changes to all billing staff, coders, and clinical providers. Failure to implement before October 1, 2025 may result in claim denials and compliance violations.