MedicaidBilling CodesHigh impact
BT2026171: IHCP corrects claim processing for FQHC and RHC encounter billing of codes T1015 and D9999
Indiana Medicaid (IHCP)·IN · Family Medicine, General Practice, Dentistry·Reimbursement
Effective date
Jan 1, 2027
We identified it
Oct 14, 2026
Summary
The Indiana Health Coverage Programs (IHCP) is implementing a systematic validation correction for FQHC and RHC claims effective January 1, 2027. Starting on this date, the FFS claim-processing system will require that every T1015 (medical encounter) or D9999 (dental encounter) code billed for a specific date of service must be accompanied by at least one valid encounter code from the IHCP-approved Myers and Stauffer Annual Encounter Code Listings for that same date. T1015 or D9999 details without a corresponding valid encounter code will be denied with no reimbursement. This corrects a previous processing gap where some multi-DOS claims were not being validated against this existing requirement.
Action Required
By January 1, 2027: Billing team must implement the following workflow changes for all FQHC and RHC claims submitted to IHCP: (1) For any claim containing multiple T1015 or D9999 encounter codes with different dates of service, split each encounter code onto separate detail lines by DOS with only one unit per line; (2) For each T1015 or D9999 detail line, verify and include at least one valid encounter code from the current Myers and Stauffer Annual Encounter Code Listings (available at myersandstauffer.com) for the identical DOS before claim submission; (3) Ensure no span dates are used for any service details on FQHC/RHC claims; (4) Verify that any other services provided on multiple encounter dates are also split and billed on separate detail lines for each DOS. Billing staff should review the Myers and Stauffer encounter code list regularly (updated annually) and confirm each T1015/D9999 detail has supporting valid encounter codes during pre-submission claim review. Failure to include valid encounter codes will result in denial of the T1015/D9999 detail line with zero reimbursement for that date of service. MCOs contracting with IHCP must also ensure their systems accept multi-DOS T1015/D9999 claims with corresponding valid encounters by this date.