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Idaho Medicaid: New billing updates for diabetes equipment and supplies

UnitedHealthcare·ID · Endocrinology, Family Medicine, Internal Medicine +1 more·State news
Effective date
Apr 1, 2026
We identified it
Jun 13, 2026
Days to comply

Summary

Idaho Medicaid is moving billing for diabetes supplies and insulin administration equipment from medical benefit to pharmacy benefit effective April 1, 2026. During the transition period (Jan 1 - March 31, 2026), providers can bill either benefit, but after April 1st, all these codes must be billed through pharmacy or claims will be denied.

Action Required

Action needed
By April 1, 2026: Billing team must update system to route all diabetes 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 pharmacy benefit instead of medical benefit for Idaho Medicaid patients. Update billing software rules and train staff on new workflow. Claims billed to medical benefit after April 1st will be denied.

Affected Billing Codes

A4206
A4211
A4238
A4239
A4245
A4250
A4253
A4256
A4258
A4259
A4271
A9275
A9276
A9277
A9278
E0607
E0784
E2100
E2101
E2102
E2103
E2104
Idaho Medicaid: New billing updates for diabetes equipment and supplies | UnitedHealthcare | PolicyChanges.app