MedicaidReimbursementMedium impact
BT2023112: Changes to reimbursement for eligible out-of-state children’s hospitals extended
Indiana Medicaid (IHCP)·IN · Pediatrics·Claims & Billing
Effective date
Jul 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs will continue reimbursing eligible out-of-state children's hospitals at 130% of standard Medicaid rates for both inpatient and outpatient services. This enhanced reimbursement applies to patients under 19 years old at specific bordering-state children's hospitals from July 1, 2023, through June 30, 2025.
Action Required
Immediately: Billing team must verify if your practice refers pediatric patients (under 19) to any of the 12 listed out-of-state children's hospitals. Update billing expectations to account for 130% Medicaid reimbursement rates for these facilities. Monitor for upcoming mass claim adjustments after CMS approval. If your practice qualifies as an eligible children's hospital but wasn't contacted, email INHospital@mslc.com.