MedicaidCoverageMedium impact
BT2025178: IHCP updates guidelines to allow optometrists to bill chalazion excision services
Indiana Medicaid (IHCP)·IN · Optometry·Provider Bulletin
Effective date
Jan 12, 2026
We identified it
Jun 18, 2026
Summary
Indiana Medicaid (IHCP) is expanding coverage to allow optometrists to bill for chalazion excision services (removal of chronic eyelid growths) using CPT codes 67800, 67801, and 67805. This change applies to all IHCP programs including HIP, Hoosier Care Connect, and Traditional Medicaid, with no prior authorization required.
Action Required
By January 12, 2026: Billing team must update system to allow optometrists (provider type 18, specialty 180) to bill CPT codes 67800, 67801, and 67805 for Indiana Medicaid patients. Update provider credentialing files and fee schedules to include these procedures for optometry providers. No prior authorization setup required for these codes.