BT2026109: Procedure code 36466 may have reimbursed incorrectly; claims to be adjusted or reprocessed

REQUIREMENTS: - By August 5, 2026: Monitor remittance advices (RAs) for adjusted claims related to CPT 36466 with internal control numbers (ICNs)/Claim IDs beginning with 52, indicating mass replacements for non-check-related adjustments. Billing team should verify that all claims from January 1, 2024 through April 14, 2026 have been properly reprocessed at the corrected rate of $1,316.52. - For FFS claims: No action required from the billing team; IHCP will perform automatic mass adjustments. Verify receipt of adjustments on RAs starting August 5, 2026. - For MCO-covered claims: Billing team must immediately identify any claims paid by managed care organizations (MCOs) for procedure code 36466 between January 1, 2024 and April 14, 2026. Contact the applicable MCO directly to request claim adjustment to the correct reimbursement rate of $1,316.52. - For questions regarding FFS reimbursement: Contact Gainwell Technologies Customer Assistance at 800-457-4584 or Provider Relations consultant. - For questions regarding MCO reimbursement: Contact the MCO with which the member is enrolled. Failure to identify and pursue MCO adjustments may result in underpayment for affected claims.