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MedicaidAdministrativeMedium impact

BT202465: IHCP to reprocess ABA therapy service claims that denied in error

Indiana Medicaid (IHCP)·IN · Psychiatry·Specialty Services
Effective date
Jun 19, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Medicaid identified a system error that caused ABA therapy claims with dates of service before January 1, 2024 to deny incorrectly for codes 97153-97158, 0362T and 0373T. The system has been fixed and applicable claims will be automatically reprocessed starting June 19, 2024.

Action Required

Action needed
Starting June 19, 2024: Monitor remittance advices for automatically reprocessed ABA therapy claims with ICNs/Claim IDs beginning with 52 (mass replacements) or 80 (reprocessed denied claims). No manual action required as IHCP will automatically adjust applicable claims that previously denied in error.

Affected Billing Codes

97153
97154
97155
97156
97157
97158