MedicaidBilling CodesMedium impact
BT202293: PRTF leave days and billing clarified
Indiana Medicaid (IHCP)·IN · Psychiatry·Claims & Billing
Effective date
Nov 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid clarified billing procedures for Psychiatric Residential Treatment Facilities (PRTFs), specifying different leave day limits and billing codes for regular Medicaid members versus DCS-placed children. Key changes include using specific T2048 modifiers for different types of stays and leave days.
Action Required
Immediately: Billing team must update system to use correct T2048 modifiers for PRTF billing - use T2048 alone for regular per diem, T2048 U1 for medical leave (max 4 days), T2048 U2 for therapeutic leave (max 14 days). For DCS-placed children, add U3 modifier to all codes (T2048 U3, T2048 U1 U3, T2048 U2 U3) and follow DCS contract requirements allowing 5 consecutive medical leave days instead of 4.