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MedicaidAdministrativeMedium impact

BT202641: IHCP corrects telehealth E/M FFS claim processing for established patient codes

Indiana Medicaid (IHCP)·IN·Telehealth
Effective date
Jan 1, 2025
We identified it
Jun 18, 2026
Days to comply

Summary

Indiana Medicaid (IHCP) corrected a system error that was inappropriately denying established patient telehealth E/M claims by applying new patient visit restrictions to the wrong codes. Previously denied claims will be automatically reprocessed and paid starting April 1, 2026.

Action Required

Action needed
Monitor remittance advices starting April 1, 2026 for reprocessed claims with ICNs beginning with 80. Continue billing established patient telehealth E/M services using codes 98004-98007 and 98012-98013 normally - no system changes needed as IHCP has corrected their processing error.

Affected Billing Codes

98004
98005
98006
98007
98012
98013