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BT202476: IHCP updates HIP preventive care services exempt from copayment

Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Gastroenterology +3 more·Managed Care
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP is updating Healthy Indiana Plan (HIP) preventive care services that are exempt from copayment, effective July 1, 2024. The policy provides an updated list of procedure codes for preventive services that qualify for copayment exemption for HIP Basic, HIP State Plan Basic, and HIP State Plan Plus Copay members, and these services are also not deducted from POWER Accounts.

Action Required

Action needed
By July 1, 2024: Billing team must update system to reflect copayment exemptions for listed preventive care procedure codes for HIP Basic, HIP State Plan Basic, and HIP State Plan Plus Copay members. Verify with member's managed care entity for service coverage before billing. Update billing rules to exclude these services from POWER Account deductions for all HIP coverage categories.

Affected Billing Codes

00812
00813
36410
36415
36416
45331
45333
45334
45338
45346
45380
45381
45382
45384
45385
45388
76775
77063
77067
77078
77080
77081
77085
77086
78350
78351
80055
80061
80081
81000
81001
81002
81003
81007
81162
81163
81164
81165
81166
81167
81212
81215
81216
81217
82270
82274
82465
82947
83036
83655
83718
83719
83721
83722
84152
84153
84154
84478
85004
85009
86328
86481
86580
86592
86631
86632
86689
86701
86702
86703
86769
86780
86803
86901
87081
87084
87086
87088
87110
87270
87320
87340
87426
87428
87485
87490
87491
87492
87534
87537
87590
87591
87592
87593
87635
87636
87637
87810
87811
90664
90666
90667
90668
G0008
G0009
G0010