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Indiana Medicaid (IHCP)Medicaid · Prior Auth · Claims & Billing · IN · Endocrinology, Family Medicine, Internal MedicineMedium impact

BT2023114: IHCP summarizes billing guidelines for diabetes testing supplies

Act
immediately
Effective date
Jan 1, 2023
Identified
Jun 19, 2026

Summary

Indiana Health Coverage Programs (IHCP) clarified billing guidelines for diabetes testing supplies, eliminating prior authorization requirements for preferred CGM products effective January 1, 2023, while maintaining PA requirements for non-preferred products. Professional claims must include 11-digit NDC or UDI codes for all diabetes testing supplies.

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What to do

immediately · 3 steps
01Billing team must verify that claims for diabetes testing supplies (CGM and SBGM) include required 11-digit National Drug Code (NDC) or unique device identifier (UDI) in billing system.
02Update claim submission processes to ensure preferred diabetes products from PDSL do not require prior authorization, while non-preferred products still need PA with medical necessity documentation.
03Pharmacy providers must submit all diabetes supply claims via point-of-sale (POS) system.

Codes mentioned

A4238A4239A4253E0607E2102E2103

Original notice

BT2023114: IHCP summarizes billing guidelines for diabetes testing supplies
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT2023138: IHCP will reprocess or mass adjust claims for select continuous glucose monitor procedure codesMediumEffective Nov 22, 2023 · Provider BulletinBT202413: IHCP no longer covers DME codes A9276, A9277 and A9278HighEffective Sep 7, 2023 · Provider BulletinBT2026117: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2026MediumEffective Jan 1, 2026 · Provider BulletinBT202582: IHCP to update rates for certain DME and medical supply items effective Jan. 1, 2025MediumEffective Jan 1, 2025 · Provider BulletinBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesEndocrinologyFamily MedicineInternal MedicineCode A4238Code A4239Code A4253Code E0607Code E2102Code E2103

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