MedicaidAdministrativeMedium impact
BT2025130: IHCP to mass adjust or reprocess claims for procedure code 96041 that denied incorrectly
Indiana Medicaid (IHCP)·IN · Oncology, OB-GYN·Claims & Billing
Effective date
Oct 8, 2025
We identified it
Jun 18, 2026
Summary
IHCP (Indiana Medicaid) identified incorrect denials for CPT code 96041 (genetic counseling) claims from January-August 2025 and will automatically reprocess affected claims. Providers will see adjusted payments on remittance advices starting October 8, 2025, or can manually resubmit claims within 180 days.
Action Required
By March 2, 2026: Monitor remittance advices starting October 8, 2025 for automatic adjustments with ICN/Claim IDs beginning with 52 or 80. If automatic adjustments are not received, manually resubmit CPT 96041 claims for dates of service January 1 - August 22, 2025 (professional) or April 1 - August 22, 2025 (institutional outpatient) with copy of bulletin attached. Contact Gainwell Technologies at 800-457-4584 with questions.