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MedicaidReimbursementHigh impact

BT2026148: IHCP corrects pricing method for certain procedure codes

Indiana Medicaid (IHCP)·IN · Cardiology, Cardiothoracic Surgery, General Surgery +6 more·Provider Bulletin
Effective date
Sep 3, 2026
We identified it
Sep 4, 2026
Days to comply

Summary

IHCP corrected an error in the pricing method for 47 procedure codes that were inadvertently changed in the fee-for-service claim-processing system between April 1–July 7, 2026. Providers can now resubmit affected claims within 180 days from September 3, 2026, with corrected pricing methods: most codes revert to SYSMAN (manually priced, requiring documentation), while others use BILL90 (90% of billed amount). Claims submitted beyond the standard filing limit must include a copy of this bulletin's first page.

Action Required

Action needed
By March 2, 2027 (180 days from September 3, 2026): Billing team must identify and resubmit all IHCP FFS claims from April 1–July 7, 2026 that include any of the 47 corrected procedure codes. For codes with SYSMAN pricing (C1721, C1722, C1749, C1777, C1779, C1780, C1785, C1786, C1882, C1895, C1896, C1898, C1899, C1900, C2621), ensure appropriate pricing documentation is attached per the Code Sets webpage at in.gov/medicaid/providers. For codes with BILL90 pricing (0655T, C1982, C2596, C2613, C7500–C7522), no additional documentation is required. When submitting claims beyond the standard filing limit, include a copy of page 1 of BT2026148. Query claims adjudicated during the error period (April 1–July 7, 2026) in the IHCP system, recalculate reimbursement under corrected pricing methods, and resubmit with supporting documentation. Failure to resubmit within the 180-day window will forfeit the opportunity to correct underpayments or recover overpayments for these procedure codes.

Affected Billing Codes

C1721
C1722
C1749
C1777
C1779
C1780
C1785
C1786
C1882
C1895
C1896
C1898
C1899
C1900
C1982
C2596
C2613
C2621
C7500
C7501
C7502
C7503
C7504
C7505
C7506
C7509
C7510
C7511
C7512
C7513
C7514
C7515
C7516
C7518
C7519
C7521
C7522