MedicaidDocumentationMedium impact
BT2025104: Face-to-face encounter and documentation requirements clarified for home health PA requests
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice·Specialty Services
Effective date
Jul 8, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid has clarified requirements for home health prior authorization requests, specifying that qualified treating practitioners must document face-to-face encounters with detailed clinical findings, and that these encounters can be conducted via telehealth. The policy establishes a rolling 12-month requirement for annual face-to-face encounters and clarifies documentation responsibilities between practitioners and home health agencies.
Action Required
Immediately: Providers treating home health patients in Indiana must ensure face-to-face encounters are documented with date of visit, detailed clinical findings, clear connections between findings and home health needs, and practitioner signatures. Home health agencies must submit comprehensive assessments with POC and CMS 485 forms. Update documentation templates to include required elements and ensure telehealth encounters follow established billing policies.