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BT202497: Coverage information for the July 2024 quarterly HCPCS update
Effective date
Jul 1, 2024
Identified
Jun 19, 2026
Summary
The Indiana Health Coverage Programs (IHCP) reviewed the July 2024 quarterly HCPCS update and published coverage information for the new codes, effective for dates of service on or after July 1, 2024, unless otherwise specified. Most of the listed codes are noncovered for all IHCP programs. The covered codes include skin-substitute codes Q4311 through Q4333, several injectable drug codes, a leadless pacemaker (C1605), and an endoscopic defect closure code (C9901).
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What to do
Action · 9 steps
01Already effective for dates of service on or after July 1, 2024, unless otherwise specified: Billing team should check the Program coverage column in Table 1 for each code before billing it.
02Codes marked Noncovered are not covered for any IHCP program.
03Codes marked Covered are covered subject to limitations established for certain benefit packages.
04Q2055 is covered effective April 4, 2024.
05The covered codes will be added to the claim-processing system.
06Pricing and additional coverage documentation for these codes were still pending at the time of the bulletin, because IHCP was awaiting final posting of the CMS fee schedules and documentation affecting coverage and pricing.
07IHCP stated it would issue a separate publication with that information after final review.
08Questions about FFS coverage should be directed to Gainwell Technologies at 800-457-4584.
09Questions about managed care coverage should be directed to the managed care entity the member is enrolled with.
Codes mentioned
9063790638A9506C1605C1606C9901G0519G0520G0521G0522G0523G0524G0525G0526G0527G0528G0529G0530G0531G9037G9038J0211J0687J0872J0911J1597J1598J1748J2183J2246J2267J2373J2468J2470J2471J3247J3263J3393J3394J7171J7355J8611J8612J9361Q2055Q4311Q4312Q4313Q4314Q4315Q4316Q4317Q4318Q4319Q4320Q4321Q4322Q4323Q4324Q4325Q4326Q4327Q4328Q4329Q4330Q4331Q4332Q4333Q5137Q5138
Original notice
BT202497: Coverage information for the July 2024 quarterly HCPCS update
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2024122: Updated coverage and billing information for the 2024 July HCPCS codesHighEffective Jul 1, 2024 · Claims & BillingBT2021113: Coverage and billing information for the 2022 annual HCPCS codes updateMediumEffective Jan 1, 2022 · Claims & BillingBT2024102: IHCP updates PA criteria for HCPCS codes Q2054 (Breyanzi) and Q2055 (Abecma)MediumEffective Mar 15, 2024 · Claims & BillingBT2024213: IHCP announces updates to pricing and coverage for certain HCPCS codesMediumEffective Dec 31, 2024 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list
Related policy hubs
Indiana Medicaid (IHCP) policiesIN policy changesOncologyWound CareCardiologyGastroenterologyCode 90637Code 90638Code A9506Code C1605Code C1606Code C9901Code G0519Code G0520Code G0521Code G0522Code G0523Code G0524Code G0525Code G0526Code G0527Code G0528Code G0529Code G0530Code G0531Code G9037Code G9038Code J0211Code J0687Code J0872Code J0911Code J1597Code J1598Code J1748Code J2183Code J2246Code J2267Code J2373Code J2468Code J2470Code J2471Code J3247Code J3263Code J3393Code J3394Code J7171Code J7355Code J8611Code J8612Code J9361Code Q2055Code Q4311Code Q4312Code Q4313Code Q4314Code Q4315Code Q4316Code Q4317Code Q4318Code Q4319Code Q4320Code Q4321Code Q4322Code Q4323Code Q4324Code Q4325Code Q4326Code Q4327Code Q4328Code Q4329Code Q4330Code Q4331Code Q4332Code Q4333Code Q5137Code Q5138