MedicaidPrior AuthMedium impact
BT202525: IHCP provides updated guidance for home health services prior authorization documentation
Indiana Medicaid (IHCP)·IN·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is requiring additional documentation for home health services prior authorization requests beginning April 1, 2025. New requirements include parent/caregiver work calendars, employment confirmation letters, member school calendars, comprehensive assessments, physician attestations within 30 days, and specific place of service coding for assisted living facilities.
Action Required
By April 1, 2025: Home health billing teams must update prior authorization workflows to collect and submit additional documentation including parent/caregiver work calendars, employment confirmation letters, member school calendars, comprehensive home health assessments identifying all other services, physician face-to-face medical necessity attestations within 30 days, and signed plans of care. Use POS code 13 for assisted living facility services and verify services are not duplicative of facility-provided care. Failure to include required documentation will result in prior authorization denials.