MedicaidReimbursementMedium impact
BT2024213: IHCP announces updates to pricing and coverage for certain HCPCS codes
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Dec 31, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) has updated pricing for 6 HCPCS codes retroactive to April-October 2024 and added coverage for injection code J2468 retroactive to July 1, 2024. Denied claims will be automatically reprocessed starting January 29, 2025, with payments appearing on February 5, 2025 remittance advices.
Action Required
By January 29, 2025: Billing team should verify that previously denied claims for codes A4564, E0152, G0138, K1037, L1320, P9027, and J2468 will be automatically reprocessed by Gainwell Technologies. Update billing system to include NDC requirements for J2468 (palonosetron injection) and ensure pricing documentation is submitted for MSRP-based codes. Monitor February 5, 2025 remittance advices for mass adjustment payments with ICN numbers beginning with 52 or 80. For any missed claims, submit within 180 days of December 31, 2024 for FFS claims or 90 days for managed care, including copy of bulletin first page.