MedicaidPrior AuthMedium impact
BT2023153: IHCP permanently removes PA for continued use of respiratory assist devices, services and supplies
Indiana Medicaid (IHCP)·IN · Pulmonology, Sleep Medicine, Critical Care +2 more·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Effective January 1, 2024, Indiana Health Coverage Programs (IHCP/Medicaid) permanently removes prior authorization requirements for continued use of respiratory assist devices including CPAP, BiPAP, and ventilator therapy. Initial authorizations are still required for new devices, but providers no longer need PA for ongoing/replacement equipment.
Action Required
By January 1, 2024: Billing team must update prior authorization workflows to remove PA requirements for continued use of respiratory devices (codes 94660, 94662, E0470-E0472, E0500, E0561-E0562, E0601) for Indiana Medicaid patients. Providers must still document medical necessity attestation and patient usage compliance in medical records. Initial PA still required for new devices.