Traditional MedicareAdministrativeMedium impact
BT202528: Electronic claim submission initiated for dually eligible members with no or exhausted Part A benefits
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Mar 26, 2025
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is now allowing electronic claim submissions for dually eligible Medicare-Medicaid members who have no or exhausted Medicare Part A benefits for inpatient acute care services. Specific adjustment reason codes and claim filing indicators must be used based on the member's Medicare Part A and B benefit status.
Action Required
By March 26, 2025: Billing team must update electronic claim submission workflows for Indiana Medicaid dually eligible members with no or exhausted Medicare Part A benefits. Configure billing system to use ARC 119 for exhausted benefits, appropriate claim filing indicators (MA for Part A exhausted, MB for Part B coverage), and set Medicare Part A paid amount to $0 when benefits are exhausted. Update IHCP Portal and 837I claim transaction templates accordingly.