MedicaidReimbursementMedium impact
BT2025177: IHCP corrects rate factor increase for outpatient mental health clinic claims
Indiana Medicaid (IHCP)·IN · Psychiatry·Claims & Billing
Effective date
Jan 1, 2025
We identified it
Jun 18, 2026
Summary
IHCP is correcting a rate factor increase of 1.088 that was incorrectly applied to professional claims for outpatient mental health clinics. The rate factor should only apply to institutional claims (UB-04), and affected professional claims from Jan 1, 2025 will be mass adjusted starting Jan 22, 2026.
Action Required
Starting Jan 22, 2026: Monitor remittance advices for adjusted claims with ICNs/Claim IDs beginning with 52 (mass replacements). Billing team should review all mental health clinic professional claims from Jan 1, 2025 forward to identify adjustments. No immediate action required as IHCP will automatically mass adjust affected claims. Contact FSSA.IHCPReimbursement@fssa.in.gov with rate questions.