MedicaidCoverageMedium impact
BT2026163: Coverage and billing information for the October 2026 quarterly HCPCS code update
Indiana Medicaid (IHCP)·IN · Pathology, Infectious Disease, OB-GYN +2 more·Reimbursement
Effective date
Oct 1, 2026
We identified it
Sep 30, 2026
Summary
Indiana Health Coverage Programs (IHCP) has released the October 2026 quarterly HCPCS code update bulletin. One code (87638 - Rubeola virus detection) is covered without prior authorization; 15 codes are noncovered under all IHCP programs. Pricing and NDC requirements are still pending from CMS. Billing teams should wait for pricing implementation before submitting claims to avoid denials.
Action Required
By October 1, 2026: (1) Billing team must halt submissions of claims using codes 0660U, 0661U, 0662U, 0663U, 0664U, 0665U, 0666U, 0667U, 0668U, 0669U, 0670U, 0671U, 0672U, 0673U, 0674U, and 0675U—these are noncovered under all IHCP programs. (2) Configure billing system to accept code 87638 (rubeola virus detection) without prior authorization requirement; this code is covered. (3) Wait for final CMS fee schedule posting and IHCP announcement before submitting claims with code 87638, as pricing has not yet been implemented. (4) Monitor in.gov/medicaid/providers for Professional Fee Schedule and Outpatient Fee Schedule updates. (5) Update internal code reference tables when IHCP posts updated code tables. Claims submitted before pricing is entered into the claim-processing system will be denied and require reprocessing. Contact Gainwell Technologies Customer Assistance at 800-457-4584 for billing/reimbursement questions; contact Acentra Health at 866-725-9991 for prior authorization questions on fee-for-service claims.