MedicaidCoverageHigh impact
BT2026131: Updated coverage and billing information for the July 2026 quarterly HCPCS code update
Indiana Medicaid (IHCP)·IN · Allergy & Immunology, Oncology, Infectious Disease +4 more·Reimbursement
Effective date
Jul 1, 2026
We identified it
Aug 5, 2026
Summary
Indiana Health Coverage Programs (IHCP) has released an updated quarterly HCPCS code bulletin (BT2026131) effective July 1, 2026, replacing the original BT2026110. The bulletin details 28 new procedure codes across multiple clinical areas (influenza vaccines, oncology testing, infectious disease serology, neurology). Critically, all 28 new codes are marked as NONCOVERED by IHCP, meaning claims submitted with these codes will be denied. Billing teams must update their systems to recognize these codes and ensure providers understand they cannot bill IHCP for these services.
Action Required
By July 1, 2026: Billing team must update the claim processing system to recognize the 28 new HCPCS procedure codes (90616, 90639, 0631U–0649U) and flag them as NONCOVERED by IHCP. Configure billing software to automatically deny or reject claims submitted with these codes under IHCP coverage. Notify all clinical staff, providers, and front-desk personnel that these codes cannot be billed to IHCP patients—patients must be informed at time of service that testing/vaccines are not covered and they may face out-of-pocket costs or should seek alternative covered options. Update encounter forms and EHR templates to display noncovered status warnings. For fee-for-service (FFS) questions, contact Gainwell Technologies Customer Assistance at 800-457-4584. For managed care plans, individual MCOs may have different coverage; direct provider inquiries to the specific MCO. Failure to implement these changes will result in claim denials, payment delays, and potential patient billing issues.