MedicaidAdministrativeMedium impact
BT202635: IHCP clarifies MRO billing for rendering providers
Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy·Claims & Billing
Effective date
Mar 12, 2026
We identified it
Jun 18, 2026
Summary
Indiana Medicaid clarifies that MRO (Medicaid Rehabilitation Option) services are reimbursed at 100% of the fee schedule with no rate adjustments based on provider type. Providers must stop using modifiers that identify rendering provider qualifications and instead document this information in the member file.
Action Required
Immediately: Billing team must stop reporting modifiers that identify qualifications of individuals rendering MRO services for Indiana Medicaid claims. Update billing system rules to remove these modifiers from MRO claims. Ensure documentation supporting who rendered the service is included in member files instead of using modifiers.