MedicaidPrior AuthMedium impact
BT202545: IHCP clarifies and corrects home health prior authorization guidance
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +16 more·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
IHCP has clarified home health prior authorization requirements, specifying that face-to-face encounters for medical necessity certification can occur via telehealth and that only the qualified treating practitioner (not the patient) needs to sign the plan of care.
Action Required
By April 1, 2025: Providers ordering home health services must ensure face-to-face encounters occur within 90 days before or 30 days after service start (telehealth acceptable). Update documentation workflows to capture practitioner signatures on home health plans of care. Billing team should verify these requirements are met before submitting home health prior authorization requests to avoid denials.