Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Indiana Medicaid (IHCP)Medicaid · Coverage · Pharmacy · IN · Oncology, NeurologyMedium impact

BT202550: IHCP updates coverage for physician-administered drug codes

Effective date
Not stated in the notice
Identified
Jun 18, 2026

Summary

Indiana Medicaid (IHCP) bulletin BT202550, issued April 24, 2025, changed coverage for two physician-administered drugs. J2253 (midazolam, Seizalam) is listed as noncovered for dates of service on or after October 1, 2024, and J9329 (tislelizumab-jsgr) is covered with prior authorization and NDC requirements for dates of service on or after October 7, 2024. This is historical material: both dates have already passed, so confirm current applicability before acting.

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 · 5 steps
01Already effective (historical; the dates have passed, so verify current IHCP rules rather than treating these as future deadlines).
02Billing team, in charge entry: stop billing J2253 for Indiana Medicaid members on dates of service from October 1, 2024 forward, because the bulletin lists it as noncovered.
03For J9329, which is effective for dates of service from October 7, 2024: confirm claims for members age 18 and older include the NDC, obtain prior authorization (the bulletin marks PA as required), keep the charge within the $57.37 maximum fee, and for institutional outpatient claims bill the procedure code linked to revenue code 636 for separate reimbursement.
04The bulletin notes J9329 may not be covered under IHCP plans with limited benefits.
05Before relying on any of this, check the current Professional and Outpatient Fee Schedules and the Procedure Codes That Require NDCs list on in.gov/medicaid/providers, since the bulletin says those will be updated to reflect these changes.

Codes mentioned

J2253J9329

Original notice

BT202550: IHCP updates coverage for physician-administered drug codes
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT2024154: Coverage and billing information for the October 2024 quarterly HCPCS codes updateHighEffective Oct 1, 2024 · Claims & BillingBT2024182: Updated coverage and billing information for the October 2024 quarterly HCPCS codes updateHighEffective Oct 1, 2024 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesOncologyNeurologyCode J2253Code J9329

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

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

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account