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BT2026174: IHCP issues further assertive community treatment billing guidance for CCBHC providers
Effective date
Not stated in the notice
Identified
Oct 21, 2026
Summary
IHCP Bulletin BT2026174 provides additional billing and operational guidance for assertive community treatment (ACT) services delivered by certified community behavioral health clinics (CCBHCs) under Indiana's Medicaid Demonstration Program. The guidance clarifies allowable services, eligibility requirements, provider qualifications, prior authorization procedures, and specific billing code requirements, including mandatory use of the V4 modifier for ACT team services and the H0039 procedure code for services not aligning with standard CCBHC encounter codes.
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What to do
Action · 3 steps
01Billing team should verify current implementation of ACT billing guidance for CCBHC claims, specifically: (1) ensure all ACT services rendered by ACT team members are billed with the V4 modifier (not Q2 modifier) on the applicable claim line; (2) confirm H0039 (Assertive community treatment, face-to-face, per 15 minutes) is used only when the service does not align with existing CCBHC encounter codes and understand it does not generate prospective payment system (PPS) payment; (3) verify all CCBHC claims include the T1040 encounter code; (4) confirm prior authorization requests are submitted with medical necessity evidence when ACT-eligible individuals exhaust their level of need (LON) 4 package units; (5) do not apply HL or HE modifiers to claims for services rendered by interns or nonenrolled practitioners billed under a supervising practitioner's NPI, and verify proper documentation in patient charts.
02Reference prior bulletin BT2025136 (effective February 1, 2026) for context.
03Direct questions to CCBHCQuestions@fssa.in.gov.
Codes mentioned
H0039T1040
Original notice
BT2026174: IHCP issues further assertive community treatment billing guidance for CCBHC providers
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2025136: IHCP announces CCBHC program updates and remindersHighEffective Feb 1, 2026 · Specialty ServicesBT202675: IHCP announces clarifications to the policies and billing procedures for the CCBHC programMediumEffective Feb 1, 2026 · Claims & BillingBT2026150: IHCP to adjust CCBHC claimsMediumEffective Oct 14, 2026 · Provider BulletinBT2024193: FSSA announces new CCBHC pilot programMediumEffective Jan 1, 2025 · Specialty ServicesBrowse every Indiana Medicaid (IHCP) change in the policy list