MedicaidReimbursementMedium impact
BT2025103: Changes to Medicaid reimbursement for eligible out-of-state children’s hospitals extended
Indiana Medicaid (IHCP)·IN · Pediatrics·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 18, 2026
Summary
Indiana has extended increased Medicaid reimbursement for eligible out-of-state children's hospitals from July 1, 2025 to July 1, 2027. These hospitals will receive 130% of standard Medicaid rates for inpatient and outpatient services for patients under 19 years old.
Action Required
By July 1, 2025: Billing team must verify if your practice treats pediatric patients at any of the 13 listed out-of-state children's hospitals in bordering states. Update billing system to apply 130% reimbursement rate for eligible hospitals for patients under 19. Monitor for CMS approval bulletin and subsequent mass claim adjustments. Contact Myers and Stauffer at INHospital@mslc.com if you believe you qualify but haven't been notified.