MedicaidReimbursementHigh impact
BT2024206: IHCP to mass adjust/reprocess claims for APRNs, CRNAs and physician assistants
Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) is implementing retroactive rate adjustments for APRNs, CRNAs, and physician assistants, moving from Indiana Medicaid policies to Medicare reimbursement rates. Claims will be automatically mass adjusted/reprocessed starting January 8, 2025, and providers can submit retroactive claims within 180 days of this bulletin for services back to April 1, 2024.
Action Required
By January 8, 2025: Billing team should monitor remittance advices for automatically adjusted claims with ICNs beginning with '52'. If submitting retroactive claims for APRN, CRNA, or physician assistant services from April 1, 2024 forward, include the first page of this bulletin with claims beyond standard filing limits. Update billing procedures to reflect new Medicare-based reimbursement rates: APRNs at 85%, CRNAs at 50% (medically directed) or 100% (not medically directed) with appropriate QX/QZ modifiers, and physician assistants at 85%.