MedicaidCoverageMedium impact
BT2022109: IHCP updates coverage for behavioral health diagnosis codes
Indiana Medicaid (IHCP)·IN · Psychiatry·Medical Policy
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) removed 12 behavioral health diagnosis codes from coverage for MRO and BPHC programs, while adding one new diagnosis code for bridge appointments. These changes affect which diagnosis codes can be used for certain behavioral health services and are retroactive to October 1, 2022.
Action Required
Immediately: Billing team must stop using 12 removed diagnosis codes (F1090, F1091, F1191, F1291, F1391, F1491, F1591, F1691, F1891, F1991, T43652D, T43652S) for Indiana Medicaid MRO and BPHC services retroactive to October 1, 2022. Add T43652A as allowable diagnosis code for bridge appointments. Update billing software rules and review any claims submitted since October 1, 2022 with these codes for potential resubmission. Claims with removed codes will be denied.