MedicaidAdministrativeMedium impact
BT202543: IHCP clarifies billing requirements for ABA claims with primary payers
Indiana Medicaid (IHCP)·IN · Psychiatry·Claims & Billing
Effective date
Mar 27, 2025
We identified it
Jun 19, 2026
Summary
IHCP clarifies that for ABA therapy claims, if the primary payer doesn't recognize RBT or BCaBA providers, the primary claim must be submitted with a supervising BCBA or HSPP as the rendering provider, while the secondary Medicaid claim should list the actual RBT/BCaBA provider along with TPL information.
Action Required
Immediately: Billing team must update ABA claim submission workflow to check if primary payers recognize RBT or BCaBA providers. For non-recognizing payers, submit primary claims with supervising BCBA or HSPP as rendering provider, then submit secondary Medicaid claims with actual RBT/BCaBA provider plus TPL information. Update billing system rules and staff training accordingly.