MedicaidCoverageMedium impact
BT2025135: IHCP updates coverage for the Family Planning Eligibility Program effective Oct. 30, 2025
Indiana Medicaid (IHCP)·IN · Urology, Radiology, OB-GYN·Medical Policy
Effective date
Oct 30, 2025
We identified it
Jun 18, 2026
Summary
Effective October 30, 2025, Indiana Medicaid's Family Planning Eligibility Program will no longer cover 4 specific procedure codes (urethral procedures, chest X-ray, fungal culture) and sterilization encounters (Z302). Claims with these codes will be denied for Family Planning program members.
Action Required
By October 30, 2025: Billing team must update system to flag CPT codes 53230, 53260, 71045, 87101 and ICD-10 code Z302 as non-covered for Indiana Medicaid Family Planning Eligibility Program members. Verify member enrollment in Family Planning program before billing these codes. Claims will be denied if submitted after effective date.