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MedicaidAdministrativeMedium impact

BT202672: IHCP corrects processing for recovery room outpatient claims when Medicare is primary payer

Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
May 12, 2026
We identified it
Jun 18, 2026
Days to comply

Summary

IHCP is now enforcing claim processing edits that will deny outpatient recovery room claims (revenue code 710) for dual eligible members when Medicare is the primary payer. Claims must be submitted to Medicare first or will be denied with EOB code 2502.

Action Required

Action needed
Immediately: Billing team must verify Medicare coverage before submitting any outpatient claims with revenue code 710 to IHCP. Always submit to Medicare first for dual eligible members. Do not bill IHCP as primary for services covered by Medicare Part B or Part D. Review all outpatient billing practices for revenue code 710. Expect recoupment adjustments on RAs beginning June 17, 2026 with ICNs starting with 52 or 80.