MedicaidCoverageMedium impact
BT202648: IHCP announces additional COVID-19 coverage changes due to American Rescue Plan expiration
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, OB-GYN +1 more·Medical Policy
Effective date
Oct 1, 2024
We identified it
Jun 18, 2026
Summary
Due to American Rescue Plan expiration, Indiana Health Coverage Programs (IHCP) has removed 6 specific COVID-19 related diagnosis codes from coverage under the Presumptive Eligibility for Pregnant Women (PEPW) program. This change affects COVID-19 screening, exposure, observation, and immunization encounters for pregnant women on Medicaid.
Action Required
Immediately: Billing team must update coding systems to exclude diagnosis codes Z03.818, Z11.52, Z11.59, Z20.822, Z20.828, and Z23 from PEPW coverage for all dates of service October 1, 2024 and forward. Review and reprocess any denied claims with these codes from October 2024 onward. Update encounter forms and EMR templates to alert providers that these COVID-19 related diagnoses no longer qualify for PEPW Medicaid coverage.