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Indiana Medicaid (IHCP)Medicaid · Billing Codes · Claims & Billing · IN · NephrologyHigh impact

BT202670: IHCP removes certain procedure codes from the renal dialysis composite rate

Act
immediately
Effective date
May 7, 2026
Identified
Jun 18, 2026

Summary

Indiana Health Coverage Programs (IHCP) removed three ESRD drug codes (J0605, J0609, J0911) from the renal dialysis composite rate, effective immediately with retroactive application. These codes will now be separately reimbursed when billed with proper documentation and NDC information for ESRD patients receiving outpatient dialysis.

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What to do

immediately · 5 steps
01Billing team must update workflows to bill codes J0605, J0609, and J0911 separately from renal dialysis composite rate.
02Include appropriate units and NDC information on claims.
03Ensure clinical documentation supports ESRD-related use consistent with TDAPA criteria.
04Monitor remittance advices beginning June 10, 2026 for reprocessed claims with ICNs starting with 52.
05Do not bill these codes on same date of service as renal dialysis composite-rate revenue codes as they will not be separately reimbursed.

Codes mentioned

J0605J0609J0911

Original notice

BT202670: IHCP removes certain procedure codes from the renal dialysis composite rate
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202604: Procedure codes added to renal dialysis composite rateMediumEffective Jan 8, 2026 · Claims & BillingBT2024211: Coverage and billing information for the 2025 annual HCPCS code updateHighEffective Jan 1, 2025 · Claims & BillingBT202520: Updated coverage and billing information for the 2025 annual HCPCS code updateHighEffective Jan 1, 2025 · Claims & BillingBT202497: Coverage information for the July 2024 quarterly HCPCS updateMediumEffective Jul 1, 2024 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesNephrologyCode J0605Code J0609Code J0911

Summaries are AI-assisted. Always confirm against the original payer notice.

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