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MedicaidReimbursementLow impact

BT2025116: IHCP corrects pricing for HCPCS code 36415 in the claim-processing system

Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Jan 1, 2025
We identified it
Jun 18, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) corrected the reimbursement rate for CPT code 36415 (blood draw) from $8.57 to $8.83. Claims with dates of service from January 1, 2025 forward will be automatically adjusted, with adjustment notices appearing on remittance advices starting September 10, 2025.

Action Required

Action needed
No immediate action required. Monitor remittance advices starting September 10, 2025 for mass adjustments with ICNs beginning with 52. If resubmitting claims for CPT 36415 beyond standard filing limits, include a copy of bulletin BT2025116 with the claim submission.

Affected Billing Codes

36415