MedicaidReimbursementMedium impact
BT2023177: CMS approves extension to reimbursement changes for eligible out-of-state children’s hospitals
Indiana Medicaid (IHCP)·IN · Pediatrics·Claims & Billing
Effective date
Jul 1, 2023
We identified it
Jun 19, 2026
Summary
CMS has approved an extension for Indiana Medicaid to reimburse eligible out-of-state children's hospitals at 130% of the standard Medicaid rate for both inpatient and outpatient services. This enhanced reimbursement applies to patients under 19 years old and extends through June 30, 2025.
Action Required
Immediately: Billing team must verify that claims for patients under 19 years old at the 13 listed out-of-state children's hospitals are being reimbursed at 130% of standard Medicaid rates. Update billing system to reflect enhanced reimbursement rates for these specific facilities through June 30, 2025. Contact Myers and Stauffer at INHospital@mslc.com if your facility meets HEA 1313 requirements but hasn't been contacted.