Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Indiana Medicaid (IHCP)Medicaid · Billing Codes · Specialty Services · IN · PsychiatryHigh impact

BT2025136: IHCP announces CCBHC program updates and reminders

Effective date
Feb 1, 2026
Identified
Jun 18, 2026

Summary

CCBHC claims must be reported with procedure code T1040 and include procedure codes for all services provided during the encounter, billed with the appropriate modifier, plus at least one triggerable code from the CCBHC valid encounter code list to be reimbursable. Effective Feb. 1, 2026, CCBHC encounter services billed with T1040 are paid at zero dollars instead of denying with EOB code 4283, and claims without a valid CCBHC encounter code for the same date of service as T1040 deny with EOB code 4284. Claims without T1040 deny with EOB code 4288 retroactive to dates of service on or after Jan. 1, 2025, and ACT services are no longer billable with H0039 and are billed with service-specific procedure codes and modifier V4 instead.

Get alerts when payers change rules like this one

We check Indiana Medicaid (IHCP) and other payers every day and email you when a change matches your specialty and state.

Get Indiana Medicaid (IHCP) alertsPolicy Monitoring is free. No card required.

What to do

Action · 14 steps
01Already effective Feb.
021, 2026: Billing team must bill T1040 on CCBHC claims and bill every service provided during the encounter with the appropriate modifier.
03Each claim needs at least one triggerable code from the CCBHC valid encounter code list, and there must be a paid encounter service for T1040 to pay at the prospective payment system rate.
04Services billed without a valid encounter require T1040, which may be billed with a zero dollar or $0.01 charge.
05Claims without a valid CCBHC encounter code for the same date of service as T1040 deny with EOB code 4284, and claims submitted with different detail span dates of service deny with EOB code 4285.
06Bill ACT services with the service-specific procedure codes and modifier V4 instead of H0039, and use modifier V4 only on services provided by an ACT team member.
07Provide T1007 and T1016 face to face, because these services deny with EOB code 6768 when billed with modifier 93.
08Do not bill the same service at both a CMHC and a CCBHC for the same member on the same day.
09A CMHC claim submitted after a paid CCBHC claim for the same service denies with EOB code 6356, and a CMHC claim already paid before a CCBHC claim is submitted is recouped with EOB code 6357.
10Use modifier XE on CMHC MRO services only in the two circumstances the source lists, and do not use XE for any other reason.
11Claims for MRO LON 4 units beyond the package need prior authorization, or they deny or cut back with EOB code 6358.
12For members enrolled with commercial insurance, submit TPL on the claim, or the claim denies with system edit CCBHC mbr cvrd by private insurance.
13MRO services for those members do not require TPL.
14Submit CCBHC claims billed to Medicare under the CMHC NPI that cross over automatically to Medicaid by voiding them and submitting directly to Gainwell Technologies under the CCBHC Provider ID.

Codes mentioned

T1040H0039T1007T1016

Original notice

BT2025136: IHCP announces CCBHC program updates and reminders
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202675: IHCP announces clarifications to the policies and billing procedures for the CCBHC programMediumEffective Feb 1, 2026 · Claims & BillingBT2026174: IHCP issues further assertive community treatment billing guidance for CCBHC providersMediumNo effective date · ReimbursementBT202629: IHCP presents status of claim-processing payment of impacted CCBHC claimsMediumEffective Jan 28, 2026 · Claims & BillingBT202633: IHCP presents an updated status of claim-processing payment of impacted CCBHC claimsMediumEffective Mar 10, 2026 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesPsychiatryCode T1040Code H0039Code T1007Code T1016

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account