MedicaidCoverageMedium impact
BT202568: IHCP announces new pharmacist provider specialty enrollment and reimbursement
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 18, 2026
Summary
Effective July 1, 2025, Indiana Medicaid will allow licensed pharmacists to enroll as rendering providers to bill for evaluation and management services related to hormonal contraceptives. Pharmacists must link to group providers and can only bill specific E&M codes for contraceptive encounters.
Action Required
Before July 1, 2025: Healthcare groups wanting to utilize pharmacist services must update their billing systems to support pharmacist rendering providers using specialty code 241. Configure systems to bill CPT codes 99202 and 99212 with specified contraceptive diagnosis codes when pharmacist NPIs are used as rendering providers. Ensure pharmacies convert to group provider classification if they want to bill for these services.