Idaho Medicaid: New billing updates for diabetes equipment and supplies
AI Summary
Idaho Medicaid is moving billing for diabetes equipment and supplies from medical benefits to pharmacy benefits effective April 1, 2026. A transition period allows billing to either benefit from January 1 through March 31, 2026, but after April 1, claims must go through pharmacy benefits or they will be denied.
Action Required
By April 1, 2026: Billing team must update systems to route all diabetes equipment and supply codes (A4206, A4211, A4238, A4239, A4245, A4250, A4253, A4256, A4258, A4259, A4271, A9275, A9276, A9277, A9278, E0607, E0784, E2100, E2101, E2102, E2103, E2104) to Idaho Medicaid pharmacy benefits instead of medical benefits. Update billing software rules and staff training. Claims submitted to medical benefits after April 1 will be denied.
Affected Billing Codes
Plan Types
Medicaid
States
ID
Specialties
endocrinology, family-medicine, internal-medicine, general-practice