MedicaidAdministrativeMedium impact
BT202539: IHCP delays enforcement of ABA rendering provider requirement to July 1, 2025
Indiana Medicaid (IHCP)·IN · Psychiatry·Specialty Services
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) has delayed the enforcement deadline for requiring rendering provider NPIs to match procedure code modifiers on ABA therapy claims from April 1, 2025 to July 1, 2025. Billing teams must ensure the correct modifier (U1, U2, or U3) matches the provider specialty performing the service.
Action Required
By July 1, 2025: Billing team must update ABA therapy claims to ensure rendering provider NPI matches the procedure code modifier - use U1 for RBT (Specialty 625), U2 for BcaBA (Specialty 624), and U3 for BCBA/BCBA-D/HSPP (Specialty 615). Update billing system edits to verify modifier alignment with provider credentials before claim submission to prevent denials.