MedicaidReimbursementHigh impact
BT2026143: IHCP announces changes to the Professional Fee Schedule and anesthesia conversion factor for 2027
Indiana Medicaid (IHCP)·IN·Reimbursement
Effective date
Jan 1, 2027
We identified it
Aug 28, 2026
Summary
Indiana Health Coverage Programs (IHCP) is updating its Professional Fee Schedule effective January 1, 2027, to reflect 100% of Medicare's 2026 fee schedule rates for physician services, DME, medical supplies, and transportation services. The anesthesia conversion factor will change to $19.58. Certain services (ABA therapy, dental, home health, HCBS waiver, MRO, and 21st Century Cures Act DME codes) are excluded from these changes. MCOs must align their fee schedules by January 1, 2027.
Action Required
By December 31, 2026: (1) Billing team must obtain updated IHCP Professional Fee Schedule from the IHCP Fee Schedules webpage (in.gov/medicaid/providers) and review preview fee schedules for physician services, DME/medical supplies, NEMT, and ambulance/EMT services. (2) Update billing system software and fee schedules to reflect new 2027 reimbursement rates effective January 1, 2027. (3) Verify anesthesia conversion factor is updated to $19.58 in all billing and claims processing systems. (4) For MCO contracted services: confirm with each MCO that their fee schedules mirror IHCP rates by the effective date. (5) Providers must verify that excluded services (ABA, dental, home health, HCBS waiver, MRO) are NOT updated to the new rates. (6) Monitor IHCP communications for 21st Century Cures Act HCPCS code list and be prepared for retroactive rate updates once CMS releases the list. Failure to implement accurate rates will result in improper reimbursement and potential claim adjustments.