Idaho Medicaid: New billing updates for diabetes equipment and supplies
AI Summary
Idaho Medicaid is moving billing for diabetes equipment and supplies from medical benefits to pharmacy benefits effective April 1, 2026. This affects 17 HCPCS codes including blood glucose monitors, test strips, insulin syringes, and continuous glucose monitoring supplies.
Action Required
By April 1, 2026: Billing team must update system to route all diabetes supply codes (A4206, A4211, A4238, A4239, A4245, A4250, A4253, A4256, A4258, A4259, A4271, A9275, A9276, A9277, A9278, E0607, E0784, E2100, E2101, E2102, E2103, E2104) to pharmacy benefits instead of medical benefits for Idaho Medicaid patients. During transition period (Jan 1 - March 31, 2026), claims can be billed to either benefit but avoid duplicate billing. Claims submitted to medical benefits after April 1 will be denied.
Affected Billing Codes
Plan Types
Medicaid
States
ID
Specialties
endocrinology, family-medicine, internal-medicine