MedicaidCoverageMedium impact
BT202578: IHCP announces coverage of additional biomarker testing codes
Indiana Medicaid (IHCP)·IN · Oncology, Hematology, Pathology·Medical Policy
Effective date
May 1, 2025
We identified it
Jun 18, 2026
Summary
IHCP (Indiana Medicaid) has expanded coverage to include 5 additional biomarker testing codes for cancer diagnosis and monitoring, all requiring prior authorization. These codes are now covered retroactively for dates of service on or after May 1, 2025.
Action Required
Immediately: Billing team must update systems to bill newly covered biomarker testing codes 0239U, 81195, 81541, 0329U, and 81462 for Indiana Medicaid patients with dates of service on or after May 1, 2025. Configure billing software to require prior authorization for all 5 codes. Update encounter forms to remind providers that PA is mandatory. Submit retroactive claims for eligible services since May 1, 2025.