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BT2024156: IHCP clarifies guidelines for using MRO billing and prior authorization codes
Act
immediately
Effective date
Oct 1, 2024
Identified
Jun 19, 2026
Summary
Indiana Medicaid clarifies which MRO (Medicaid Rehabilitation Option) codes should be used for prior authorization requests versus billing claims. Some codes can be used for both PA and billing, while others are billing-only codes that cannot be requested in PA submissions.
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What to do
immediately · 4 steps
01Billing team must update prior authorization submission procedures for Indiana Medicaid MRO services.
02Use only the specified PA codes from Table 1 when requesting additional units (e.g., use H0004 HW for PA but can bill with H0004 HW, H0004 HW HR, or H0004 HW HS).
03Submit PA requests to Acentra Health via Atrezzo Provider Portal, fax, phone or mail.
04PA requests using billing-only codes will be rejected.
Codes mentioned
T1016H0031H2017H0004H0034H2014H2035H0005H2012H2019H2011H0015S9480H0038
Original notice
BT2024156: IHCP clarifies guidelines for using MRO billing and prior authorization codes
in.gov · Always check the source before changing claims.
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