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MedicaidCoverageHigh impact

BT202695: IHCP presents status of claim-processing payment for impacted CCBHC claims

Indiana Medicaid (IHCP)·IN · Psychiatry·Claims & Billing
Effective date
Jun 5, 2026
We identified it
Jun 18, 2026
Days to comply

Summary

Indiana Medicaid has identified ongoing claim processing issues for CCBHCs stemming from a January 2026 system implementation. Key updates include crossover physician claims denying, claims suspending for private insurance coordination, and effective June 5, 2026 (retroactive to January 1, 2025), audio-only telehealth for procedure codes T1007 and T1016 will be denied with potential recoupment of previously paid claims.

Action Required

Action needed
By June 5, 2026: Billing teams must stop billing procedure codes T1007 and T1016 with modifier 93 (audio-only telehealth) for Indiana Medicaid CCBHC claims. Update billing system to flag these combinations for denial. Review all claims with these codes from January 1, 2025 forward as they will be subject to mass adjustment or recoupment. Monitor for additional communications regarding adjustment timelines.

Affected Billing Codes

T1007
T1016