MedicaidCoverageLow impact
BT2025145: Corrections announced to previously published Family Planning Eligibility Program coverage
Indiana Medicaid (IHCP)·IN · Urology, OB-GYN, Family Medicine·Medical Policy
Effective date
Oct 30, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid corrected their previous bulletin about Family Planning Eligibility Program coverage changes. Two urological procedures (CPT 53230, 53260) will be removed from coverage, while a chest X-ray (CPT 71045), fungal culture (CPT 87101), and sterilization encounters (ICD Z302) will remain covered contrary to the previous bulletin.
Action Required
Before October 30, 2025: Billing team must update system to remove coverage for CPT 53230 (excision of urethral diverticulum) and CPT 53260 (excision/fulguration of urethral polyp) for Indiana Medicaid Family Planning Eligibility Program and PE-Family Planning Services members. Verify that CPT 71045, 87101, and ICD Z302 remain active for these programs. Update encounter forms and notify providers treating Family Planning Eligibility patients.