MedicaidPrior AuthMedium impact
BT202255: IHCP clarifies prior authorization criteria for specialized car seats and car beds
Indiana Medicaid (IHCP)·IN · Pediatrics, PM&R (Physical Medicine & Rehab), Physical Therapy +2 more·Prior Authorization
Effective date
Aug 19, 2022
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) now requires prior authorization for specialized car seats and car beds billed under HCPCS code E1399, effective August 19, 2022. Medical necessity must meet specific criteria including limb spasticity, muscle flaccidity, spinal deformity, or special therapist evaluation.
Action Required
By August 19, 2022: Billing team must update system to require prior authorization for HCPCS code E1399 (specialized car seats/car beds) for Indiana Medicaid fee-for-service members. Contact Gainwell Technologies at 800-457-4584, option 7 for prior authorization requests. Ensure documentation includes one of the specified medical necessity criteria (limb spasticity, muscle flaccidity, spinal deformity, or therapist evaluation). Submit manufacturer invoice and MSRP with claims as reimbursement is manually priced at 75% MSRP or 120% of cost invoice.