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BT202582: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2025

Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Orthopedics·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 18, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) updated reimbursement rates for numerous durable medical equipment (DME) and medical supply HCPCS codes effective January 1, 2025, with rates now based on 2025 Medicare DMEPOS Fee Schedule amounts under the 21st Century Cures Act. Mass claim adjustments are being processed with adjusted claims appearing on remittance advices beginning July 9, 2025.

Action Required

Action needed
Monitor remittance advices beginning July 9, 2025 for mass claim adjustments with ICNs/Claim IDs beginning with 52. Update billing system with new maximum fees for affected DME codes listed in Table 1, noting corrected RR modifiers for codes E0439 and K0860. Review and update fee schedules from IHCP Fee Schedules page when next regular update is published.

Affected Billing Codes

A5514
A7007
A7017
E0100
E0105
E0110
E0111
E0112
E0113
E0114
E0116
E0130
E0135
E0140
E0141
E0143
E0144
E0147
E0148
E0149
E0160
E0161
E0163
E0165
E0167
E0168
E0170
E0181
E0183
E0184
E0185
E0186
E0188
E0189
E0196
E0197
E0199
E0210
E0235
E0250
E0251
E0255
E0256
E0260
E0261
E0265
E0277
E0290
E0291
E0292
E0293
E0294
E0295
E0300
E0301
E0439
K0860