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BT2023123: Coverage and billing information for the 2023 October HCPCS codes update
Effective date
Oct 1, 2023
Identified
Jun 19, 2026
Summary
Codes added in the October 2023 quarterly HCPCS update have Indiana Medicaid (IHCP) coverage, prior authorization and billing rules, effective for dates of service on or after October 1, 2023. Codes are marked Covered or Noncovered, and some require prior authorization or NDC. Skin-substitute codes are reimbursed at a flat, statewide, per-unit rate, and several new codes are linked to revenue code 636.
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What to do
Action · 8 steps
01Already effective October 1, 2023 for dates of service on or after that date: Billing team: For each code in Table 1, bill it using the program coverage, prior authorization required, NDC required and special billing information listed for that code.
02Codes marked Noncovered are not covered by the IHCP for any program.
03For codes that require prior authorization, use the PA criteria in Table 5.
04Direct fee-for-service reimbursement and billing questions to Gainwell Technologies at 800-457-4584 and fee-for-service PA questions to Kepro Customer Service at 866-725-9991.
05For members in managed care, direct reimbursement, PA and billing questions to the managed care entity the member is enrolled with.
06Code B4148 is included in the LTC facility per diem rate (Table 7).
07Table 8 lists end-dated codes with alternate code considerations, and inclusion of an alternate code does not indicate IHCP coverage of it, so check the Professional Fee Schedule for coverage.
08Check current applicability before relying on this notice.
Codes mentioned
904809131891319913209132191322A2022A2023A2024A2025A9156A9268A9269A9292A9573A9603A9697B4148C9152C9153C9154C9155C9156C9157C9158C9788C9789C9790C9791C9792E0490E0491H2040H2041J0349J0801J0802J0874J0889J2359J2781J7214J7353J7519J9051J9064J9345K1036L1681L5991Q4285Q4286V2526C9151J0800
Original notice
BT2023123: Coverage and billing information for the 2023 October HCPCS codes update
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2023165: Updated coverage and billing information for the 2023 October HCPCS codesMediumEffective Oct 1, 2023 · Claims & BillingBT2026182: COVID-19 vaccine administration to no longer be carved out of managed careHighEffective Jan 1, 2027 · Provider BulletinBT2023179: Coverage removed for Pfizer and Moderna COVID-19 vaccination codes; replacement codes providedMediumEffective Nov 1, 2023 · Medical PolicyBT202419: IHCP mass adjusts or reprocesses claims for COVID-19 vaccine and administration codesMediumEffective Sep 11, 2023 · Provider BulletinBrowse every Indiana Medicaid (IHCP) change in the policy list
Related policy hubs
Indiana Medicaid (IHCP) policiesIN policy changesPodiatryWound CareOncologyOrthopedicsCode 90480Code 91318Code 91319Code 91320Code 91321Code 91322Code A2022Code A2023Code A2024Code A2025Code A9156Code A9268Code A9269Code A9292Code A9573Code A9603Code A9697Code B4148Code C9152Code C9153Code C9154Code C9155Code C9156Code C9157Code C9158Code C9788Code C9789Code C9790Code C9791Code C9792Code E0490Code E0491Code H2040Code H2041Code J0349Code J0801Code J0802Code J0874Code J0889Code J2359Code J2781Code J7214Code J7353Code J7519Code J9051Code J9064Code J9345Code K1036Code L1681Code L5991Code Q4285Code Q4286Code V2526Code C9151Code J0800