MedicaidBilling CodesMedium impact
BT2025173: IHCP updates the billing policy for HCBS assisted living providers
Indiana Medicaid (IHCP)·IN · Geriatrics·Claims & Billing
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
IHCP updated billing policy for HCBS assisted living providers, requiring monthly billing code T2031 U7 UA when residents are present 28+ days per month, and daily billing code T2031 U7 when present less than 28 days. Claims can only be submitted after services are rendered, not for future dates.
Action Required
Before January 1, 2026: Billing team must update system to use monthly billing code T2031 U7 UA with modifiers U1, U2, or U3 when assisted living residents are present 28+ days per month, and daily billing code T2031 U7 with same modifiers when present less than 28 days. Configure system to prevent claims submission until after service dates are completed. Update documentation requirements to support daily services rendered. Claims submitted with incorrect billing codes will be denied by MCE or FFS contractors.