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BT2026110: Coverage and billing information for the July 2026 quarterly HCPCS code update
Effective date
Jul 1, 2026
Identified
Jul 1, 2026
Summary
The Indiana Health Coverage Programs (IHCP) bulletin BT2026110, dated June 30, 2026, gives coverage and billing information for the new codes in the July 2026 quarterly HCPCS update. The information is effective for dates of service on or after July 1, 2026. Table 1 lists each new code with its program coverage, prior authorization requirement, NDC requirement and special billing information, and codes marked Noncovered are not covered by the IHCP for any programs. The bulletin has been replaced with IHCP Bulletin BT2026131.
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What to do
Action · 6 steps
01Already effective July 1, 2026 (dates of service on or after this date): Providers are encouraged to wait until IHCP announces that pricing has been implemented for these codes before submitting claims.
02Claims submitted before pricing is entered into the claim-processing system may initially be denied and will need to be reprocessed after pricing is added.
03For fee-for-service claims, Table 1 marks prior authorization as required for C1609, J2361, J3405, Q5164 and Q5167, and the NDC requirements and prior authorization criteria will be announced in a later IHCP publication.
04Questions about FFS prior authorization go to Acentra Health Customer Service at 866-725-9991, and questions about FFS billing and reimbursement go to Gainwell Technologies Customer Assistance at 800-457-4584.
05For managed care members, direct prior authorization, billing and reimbursement questions to the member's managed care organization.
06Standard global billing procedures and edits apply to the new codes unless special billing guidance is noted in Table 1, and C1609 is restricted to ages 35-80 years.
Codes mentioned
9061690639A9574C1609C8014C9310G0572G0573G0574G0575G0577G0669G0670G0671G0672G0673G0674G0675G0676G0677G0678G0685J0528J1289J1577J2361J2374J2789J3386J3405J7176J9053J9062J9232M0231M0232Q0234Q5164Q5165Q5166Q5167Q5168Q5169Q5170Q5171
Original notice
BT2026110: Coverage and billing information for the July 2026 quarterly HCPCS code update
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2026131: Updated coverage and billing information for the July 2026 quarterly HCPCS code updateHighEffective Jul 1, 2026 · ReimbursementBT2026163: Coverage and billing information for the October 2026 quarterly HCPCS code updateHighEffective Oct 1, 2026 · ReimbursementBT202084: July 2020 quarterly HCPCS code updates announcedMediumEffective Jul 1, 2020 · Claims & BillingBT202285: Coverage and billing information for the 2022 October quarterly HCPCS codes updateMediumEffective Oct 1, 2022 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list
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Indiana Medicaid (IHCP) policiesIN policy changesOncologyPathologyOB-GYNNeurologyCardiologyNephrologyDermatologyUrologyPulmonologyOphthalmologyGeriatricsPsychiatryInternal MedicineInfectious DiseaseVascular SurgeryRadiologyOrthopedicsCode 90616Code 90639Code A9574Code C1609Code C8014Code C9310Code G0572Code G0573Code G0574Code G0575Code G0577Code G0669Code G0670Code G0671Code G0672Code G0673Code G0674Code G0675Code G0676Code G0677Code G0678Code G0685Code J0528Code J1289Code J1577Code J2361Code J2374Code J2789Code J3386Code J3405Code J7176Code J9053Code J9062Code J9232Code M0231Code M0232Code Q0234Code Q5164Code Q5165Code Q5166Code Q5167Code Q5168Code Q5169Code Q5170Code Q5171