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Indiana Medicaid (IHCP)Medicaid · Reimbursement · Claims & Billing · INMedium impact

BT2024213: IHCP announces updates to pricing and coverage for certain HCPCS codes

Act
by Jan 29, 2025
Effective date
Dec 31, 2024
Identified
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.

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What to do

by Jan 29, 2025 · 4 steps
01Billing team should verify that previously denied claims for codes A4564, E0152, G0138, K1037, L1320, P9027, and J2468 will be automatically reprocessed by Gainwell Technologies.
02Update billing system to include NDC requirements for J2468 (palonosetron injection) and ensure pricing documentation is submitted for MSRP-based codes.
03Monitor February 5, 2025 remittance advices for mass adjustment payments with ICN numbers beginning with 52 or 80.
04For 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.

Codes mentioned

A4564E0152G0138K1037L1320P9027J2468

Original notice

BT2024213: IHCP announces updates to pricing and coverage for certain HCPCS codes
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202437: Coverage information for the April 2024 quarterly HCPCS updateMediumEffective Apr 1, 2024 · Claims & BillingBT202467: Coverage and billing information for the April 2024 Quarterly HCPCS codes updateHighEffective Apr 1, 2024 · Claims & BillingBT202497: Coverage information for the July 2024 quarterly HCPCS updateMediumEffective Jul 1, 2024 · Claims & BillingBT2024122: Updated coverage and billing information for the 2024 July HCPCS codesHighEffective Jul 1, 2024 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesCode A4564Code E0152Code G0138Code K1037Code L1320Code P9027Code J2468

Summaries are AI-assisted. Always confirm against the original payer notice.

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