MedicaidReimbursementHigh impact
BT2026119: IHCP updates reimbursement percentage for anesthesia medical direction with modifier QK
Indiana Medicaid (IHCP)·IN · Anesthesiology·Provider Bulletin
Effective date
Apr 1, 2024
We identified it
Jul 22, 2026
Summary
Indiana Health Coverage Programs (IHCP) is increasing reimbursement for anesthesia medical direction claims billed with modifier QK from 30% to 50% of the fee schedule, effective retroactively for dates of service on or after April 1, 2024. This change corrects an omission from the HIP Rate Equalization Project and clarifies duplicate billing rules when multiple anesthesia providers bill the same procedure codes.
Action Required
By August 26, 2026: Billing team must monitor remittance advices (RAs) for mass adjustments and reprocessed claims with ICNs/Claim IDs beginning with 52, which will reflect the increased 50% reimbursement rate for modifier QK claims. Verify that all anesthesia claims billed with modifier QK (CPT codes 00100-01999) for medical direction of two, three, or four concurrent procedures are processed at the new 50% rate rather than the previous 30%. Update billing system logic if necessary to ensure modifier QK claims are no longer denied as duplicates when billed alongside unmodified claims from other providers on the same DOS. Educate anesthesiologists and CRNAs on proper modifier QK usage to prevent claim denials and ensure accurate reimbursement going forward. Contact Gainwell Technologies at 800-457-4584 or your Provider Relations consultant with questions about FFS billing adjustments.