MedicaidBilling CodesMedium impact
BT202340: IHCP adds coverage for procedure code G0433
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Claims & Billing
Effective date
May 2, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is adding coverage for procedure code G0433 for HIV screening to resolve CLIA certification issues that caused denials for CPT 86703. The new code is CLIA-waived and allows providers with Certificate of Waiver to bill for HIV testing with maximum reimbursement of $18.29.
Action Required
Immediately: Billing team must add G0433 to billing system as a CLIA-waived HIV screening code with $18.29 maximum fee for Indiana Medicaid plans. Update encounter forms to include G0433 as an option for HIV testing using CLIA-waived test kits. Providers with Certificate of Waiver should use G0433 instead of 86703 to avoid CLIA-related denials. For claims denied for 86703 from Jan 1, 2019 through Dec 31, 2020, resubmit within 90 days (managed care) or 180 days (FFS) with this bulletin attached.