MedicaidCoverageMedium impact
BT202552: IHCP updates guidelines to allow optometrists to render Dextenza (68841)
Indiana Medicaid (IHCP)·IN · Optometry·Provider Bulletin
Effective date
May 29, 2025
We identified it
Jun 18, 2026
Summary
Indiana Health Coverage Programs (IHCP) now allows optometrists to perform Dextenza drug delivery implant insertions using CPT code 68841, effective May 29, 2025. This expands provider eligibility for this tear duct procedure without requiring prior authorization or NDC codes.
Action Required
By May 29, 2025: Billing team must update provider eligibility rules in billing system to allow optometrists (provider type 18, specialty 180) to bill CPT code 68841 for Dextenza procedures. Verify RBRVS pricing is loaded from Professional Fee Schedule. Update encounter forms to include this procedure for optometry services.