MedicaidReimbursementMedium impact
BT2024208: IHCP reminds providers of children’s out-of-state hospital reimbursement
Indiana Medicaid (IHCP)·IN · Pediatrics·Claims & Billing
Effective date
Jul 1, 2021
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Health Coverage Programs/Medicaid) reminds providers that eligible out-of-state children's hospitals in bordering states receive increased reimbursement rates comparable to Medicare rates or 130% of standard IHCP rates for patients under 19. This enhanced payment structure has been in effect since July 2021 and continues through June 30, 2025.
Action Required
No immediate action required - this is a reminder of existing policy. Billing team should verify that claims to eligible out-of-state children's hospitals in border states are being processed with enhanced rates for IHCP members under 19. Monitor EOB code 9046 on explanations of benefits to confirm increased reimbursement is being applied correctly.