When does this change take effect?

This change is effective Jan 1, 2025.

What do I need to do?

Already effective Jan. 1, 2025: Look for adjusted claims on remittance advices beginning July 9, 2025, with ICNs or Claim IDs that begin with 52 (mass replacements non-check-related), for the Table 1 codes that were mass adjusted. Use modifier NU for new DME purchases and modifier RR for rentals, with the updated max fee shown for each code and modifier in Table 1. The updated rates will also appear in the next regular Professional Fee Schedule update and in the applicable DME and medical supply code tables on the IHCP Code Sets page. Prior authorization, billing and reimbursement information applies to fee-for-service claims. Direct managed care PA, billing and reimbursement questions to the member's managed care entity.

← Back to list

Indiana Medicaid (IHCP)Medicaid · Reimbursement · Provider Bulletin · IN · PM&R (Physical Medicine & Rehab), Geriatrics, PulmonologyMedium impact

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

Q: Who is affected by this change?

This affects Indiana Medicaid (IHCP) PM&R (Physical Medicine & Rehab), Geriatrics, Pulmonology providers in IN on Medicaid plans.

Q: Which billing codes are affected?

The following codes are affected: 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, E0302, E0303, E0304, E0371, E0372, E0373, E0424, E0431, E0433, E0434, E0439, E0441, E0442, E0443, E0444, E0465, E0466, E0467, E0468, E0470, E0471, E0472, E0482, E0483, E0500, E0570, E0572, E0574, E0585, E0600, E0601, E0607, E0617, E0620, E0627, E0629, E0630, E0635, E0636, E0639, E0640, E0650, E0651, E0652, E0680, E0691, E0692, E0693, E0694, E0720, E0730, E0740, E0744, E0745, E0747, E0748, E0760, E0779, E0780, E0781, E0784, E0791, E0849, E0855, E0860, E0870, E0900, E0910, E0911, E0912, E0920, E0935, E0940, E0941, E1031, E1035, E1036, E1037, E1038, E1039, E1161, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E1390, E1391, E1392, E1405, E1800, E1801, E1802, E1805, E1806, E1810, E1811, E1815, E1816, E1818, E1820, E1825, E1830, E1831, E1840, E1841, E2000, E2100, E2101, E2102, E2103, E2402, E2502, E2506, E2508, E2510, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0738, K0800, K0801, K0802, K0813, K0814, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0829, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863.

Effective date

Jan 1, 2025

Identified

Jun 18, 2026

Summary

Effective for dates of service on or after Jan. 1, 2025, Indiana Medicaid (IHCP) changed the rates for select durable medical equipment (DME) and medical supply HCPCS codes, listed in Table 1 with separate NU (new purchase) and RR (rental) rates. For covered DME subject to the 21st Century Cures Act, the Medicaid allowed amount is the lowest non-zero 2025 Indiana Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule amount or competitive bidding single payment amount. Claims processed during the indicated time frame for these codes will be mass adjusted, as appropriate.

Get alerts when payers change rules like this one

We check Indiana Medicaid (IHCP) and other payers every day and email you when a change matches your specialty and state.

Get Indiana Medicaid (IHCP) alertsPolicy Monitoring is free. No card required.

What to do

Action · 6 steps

01Already effective Jan.

021, 2025: Look for adjusted claims on remittance advices beginning July 9, 2025, with ICNs or Claim IDs that begin with 52 (mass replacements non-check-related), for the Table 1 codes that were mass adjusted.

03Use modifier NU for new DME purchases and modifier RR for rentals, with the updated max fee shown for each code and modifier in Table 1.

04The updated rates will also appear in the next regular Professional Fee Schedule update and in the applicable DME and medical supply code tables on the IHCP Code Sets page.

05Prior authorization, billing and reimbursement information applies to fee-for-service claims.

06Direct managed care PA, billing and reimbursement questions to the member's managed care entity.

Codes mentioned

A5514A7007A7017E0100E0105E0110E0111E0112E0113E0114E0116E0130E0135E0140E0141E0143E0144E0147E0148E0149E0160E0161E0163E0165E0167E0168E0170E0181E0183E0184E0185E0186E0188E0189E0196E0197E0199E0210E0235E0250E0251E0255E0256E0260E0261E0265E0277E0290E0291E0292E0293E0294E0295E0300E0301E0302E0303E0304E0371E0372E0373E0424E0431E0433E0434E0439E0441E0442E0443E0444E0465E0466E0467E0468E0470E0471E0472E0482E0483E0500E0570E0572E0574E0585E0600E0601E0607E0617E0620E0627E0629E0630E0635E0636E0639E0640E0650E0651E0652E0680E0691E0692E0693E0694E0720E0730E0740E0744E0745E0747E0748E0760E0779E0780E0781E0784E0791E0849E0855E0860E0870E0900E0910E0911E0912E0920E0935E0940E0941E1031E1035E1036E1037E1038E1039E1161E1232E1233E1234E1235E1236E1237E1238E1390E1391E1392E1405E1800E1801E1802E1805E1806E1810E1811E1815E1816E1818E1820E1825E1830E1831E1840E1841E2000E2100E2101E2102E2103E2402E2502E2506E2508E2510K0001K0002K0003K0004K0005K0006K0007K0738K0800K0801K0802K0813K0814K0816K0820K0821K0822K0823K0824K0825K0826K0827K0829K0835K0836K0837K0838K0839K0840K0841K0842K0843K0848K0849K0850K0851K0856K0857K0858K0859K0860K0861K0862K0863

Original notice

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

in.gov · Always check the source before changing claims.

View original ↗

BT2026117: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2026MediumEffective Jan 1, 2026 · Provider Bulletin BT202106: IHCP to update rates for certain DME and medical supply items effective February 1, 2021MediumEffective Feb 1, 2021 · Provider Bulletin BT202320: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2023MediumEffective Jan 1, 2023 · Provider Bulletin BT202448: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2024MediumEffective Jan 1, 2024 · Provider Bulletin Browse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policies IN policy changes PM&R (Physical Medicine & Rehab)Geriatrics Pulmonology Code A5514 Code A7007 Code A7017 Code E0100 Code E0105 Code E0110 Code E0111 Code E0112 Code E0113 Code E0114 Code E0116 Code E0130 Code E0135 Code E0140 Code E0141 Code E0143 Code E0144 Code E0147 Code E0148 Code E0149 Code E0160 Code E0161 Code E0163 Code E0165 Code E0167 Code E0168 Code E0170 Code E0181 Code E0183 Code E0184 Code E0185 Code E0186 Code E0188 Code E0189 Code E0196 Code E0197 Code E0199 Code E0210 Code E0235 Code E0250 Code E0251 Code E0255 Code E0256 Code E0260 Code E0261 Code E0265 Code E0277 Code E0290 Code E0291 Code E0292 Code E0293 Code E0294 Code E0295 Code E0300 Code E0301 Code E0302 Code E0303 Code E0304 Code E0371 Code E0372 Code E0373 Code E0424 Code E0431 Code E0433 Code E0434 Code E0439 Code E0441 Code E0442 Code E0443 Code E0444 Code E0465 Code E0466 Code E0467 Code E0468 Code E0470 Code E0471 Code E0472 Code E0482 Code E0483 Code E0500 Code E0570 Code E0572 Code E0574 Code E0585 Code E0600 Code E0601 Code E0607 Code E0617 Code E0620 Code E0627 Code E0629 Code E0630 Code E0635 Code E0636 Code E0639 Code E0640 Code E0650 Code E0651 Code E0652 Code E0680 Code E0691 Code E0692 Code E0693 Code E0694 Code E0720 Code E0730 Code E0740 Code E0744 Code E0745 Code E0747 Code E0748 Code E0760 Code E0779 Code E0780 Code E0781 Code E0784 Code E0791 Code E0849 Code E0855 Code E0860 Code E0870 Code E0900 Code E0910 Code E0911 Code E0912 Code E0920 Code E0935 Code E0940 Code E0941 Code E1031 Code E1035 Code E1036 Code E1037 Code E1038 Code E1039 Code E1161 Code E1232 Code E1233 Code E1234 Code E1235 Code E1236 Code E1237 Code E1238 Code E1390 Code E1391 Code E1392 Code E1405 Code E1800 Code E1801 Code E1802 Code E1805 Code E1806 Code E1810 Code E1811 Code E1815 Code E1816 Code E1818 Code E1820 Code E1825 Code E1830 Code E1831 Code E1840 Code E1841 Code E2000 Code E2100 Code E2101 Code E2102 Code E2103 Code E2402 Code E2502 Code E2506 Code E2508 Code E2510 Code K0001 Code K0002 Code K0003 Code K0004 Code K0005 Code K0006 Code K0007 Code K0738 Code K0800 Code K0801 Code K0802 Code K0813 Code K0814 Code K0816 Code K0820 Code K0821 Code K0822 Code K0823 Code K0824 Code K0825 Code K0826 Code K0827 Code K0829 Code K0835 Code K0836 Code K0837 Code K0838 Code K0839 Code K0840 Code K0841 Code K0842 Code K0843 Code K0848 Code K0849 Code K0850 Code K0851 Code K0856 Code K0857 Code K0858 Code K0859 Code K0860 Code K0861 Code K0862 Code K0863

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

Summary

Get alerts when payers change rules like this one

What to do

Codes mentioned

Original notice

Related changes

Related policy hubs

One workspace for payer rules, prior auth, coding and compliance