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Indiana Medicaid (IHCP)Medicaid · Billing Codes · Claims & Billing · IN · Podiatry, Wound Care, Radiology +11 moreHigh impact

BT202520: Updated coverage and billing information for the 2025 annual HCPCS code update

Effective date
Jan 1, 2025
Identified
Jun 19, 2026

Summary

New codes in the 2025 annual HCPCS update are effective for dates of service on or after Jan. 1, 2025, unless otherwise specified, and they replace the update in Bulletin BT2024211. Codes marked Yes for prior authorization must meet the criteria listed in Table 4, and codes marked Noncovered are not covered for any programs. Discontinued codes in Table 13 list alternate code considerations, and an alternate code on that table does not indicate IHCP coverage of the alternate code.

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What to do

Action · 7 steps
01Already effective January 1, 2025 for dates of service on or after that date (historical, check current applicability before billing any of these codes): Billing team should bill the new codes with the standard global billing procedures and edits, unless the table gives special billing guidance.
02Billing team: for codes marked Yes for prior authorization, follow the criteria in Table 4, and direct questions about fee-for-service prior authorization to Acentra Health Customer Service at 866-725-9991.
03Managed care members: direct prior authorization and billing questions to the managed care entity the member is enrolled with.
04Billing team: for discontinued codes in Table 13, review the alternate code considerations beside each code before submitting claims.
05Billing team: for claims filed beyond the standard timely filing limit for codes in this bulletin, attach the first page of the bulletin.
06The timely filing windows ran 90 days from the February 6, 2025 publication date for managed care claims and 180 days for fee-for-service claims.
07Fee-for-service billing questions go to Gainwell Technologies Customer Assistance at 800-457-4584.

Codes mentioned

2544838225382263822738228617157601476015760167601776018760198155892137G0533G0561G0562G0563G0564G0565J0139J1307J1414J2472J2802J7601J9028Q5140Q5141Q5142Q5143Q5144Q5145E1803E1804E1807E1808E1813E1814E1822E1823E1826E1827E1828E182915012150141501615018J0601J0602J0603J0605J0607J0608J0609J0615J0870J9026J9076J15529604198000980019800298003980049800598006980079800898009980129801349203492044920590630906549389096040994419944299443C9169C9170C9172C9794C9795G0106G0120Q5131Q5132

Original notice

BT202520: Updated coverage and billing information for the 2025 annual HCPCS code update
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT2024211: Coverage and billing information for the 2025 annual HCPCS code updateHighEffective Jan 1, 2025 · Claims & BillingBT202593: IHCP updates FQHC and RHC encounter codesMediumEffective Jul 28, 2025 · Provider BulletinBT2026117: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2026MediumEffective Jan 1, 2026 · Provider BulletinBT202592: IHCP updates CCBHC encounter codesMediumEffective Jul 28, 2025 · Specialty ServicesBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesPodiatryWound CareRadiologyCardiologyNephrologyOncologyOphthalmologyOptometryUrologyDentistryOrthopedicsNeurologyPulmonologyPharmacyCode 25448Code 38225Code 38226Code 38227Code 38228Code 61715Code 76014Code 76015Code 76016Code 76017Code 76018Code 76019Code 81558Code 92137Code G0533Code G0561Code G0562Code G0563Code G0564Code G0565Code J0139Code J1307Code J1414Code J2472Code J2802Code J7601Code J9028Code Q5140Code Q5141Code Q5142Code Q5143Code Q5144Code Q5145Code E1803Code E1804Code E1807Code E1808Code E1813Code E1814Code E1822Code E1823Code E1826Code E1827Code E1828Code E1829Code 15012Code 15014Code 15016Code 15018Code J0601Code J0602Code J0603Code J0605Code J0607Code J0608Code J0609Code J0615Code J0870Code J9026Code J9076Code J1552Code 96041Code 98000Code 98001Code 98002Code 98003Code 98004Code 98005Code 98006Code 98007Code 98008Code 98009Code 98012Code 98013Code 49203Code 49204Code 49205Code 90630Code 90654Code 93890Code 96040Code 99441Code 99442Code 99443Code C9169Code C9170Code C9172Code C9794Code C9795Code G0106Code G0120Code Q5131Code Q5132

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