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BT2025123: Providers to be able to access PACE liability and transfer-of-property penalty information Sept. 25

Indiana Medicaid (IHCP)·IN · Geriatrics·Provider Bulletin
Effective date
Sep 25, 2025
We identified it
Jun 18, 2026
Days to comply

Summary

Indiana Medicaid will implement new PACE liability and transfer-of-property penalty tracking in their eligibility systems starting September 25, 2025. Providers will see new liability information when checking eligibility, and PACE providers will receive new capitation reason codes for payment reductions.

Action Required

Action needed
By September 25, 2025: Billing team must update eligibility verification workflows to check new PACE liability information in GABBY, 271 responses, and IHCP Portal. Train staff to recognize new capitation reason codes ZA, ZB, ZC, and ZD on 820 transactions. Ensure facilities only collect liability amounts shown in the portal and not exceed listed amounts.