MedicaidCoverageMedium impact
BT202259: IHCP adds coverage for CT colonography screenings
Indiana Medicaid (IHCP)·IN · Gastroenterology, Radiology, Family Medicine +1 more·Medical Policy
Effective date
Aug 30, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) will begin covering CT colonography screenings (CPT 74263) effective August 30, 2022, with no prior authorization required. This adds a new covered colorectal screening option for Medicaid patients ages 45-75 when standard colonoscopy fails, is incomplete, or contraindicated.
Action Required
By August 30, 2022: Billing team must update system to include CPT 74263 as covered for Indiana Medicaid patients ages 45-75. Ensure billing staff know to append TC or 26 modifiers for technical/professional components. Update fee schedules to reflect professional claims use RBRVS and outpatient claims reimburse at 15% of billed amount. Verify medical necessity criteria are met before billing.