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Indiana Medicaid (IHCP)Medicaid · Billing Codes · Provider Bulletin · IN · Pulmonology, Sleep Medicine, DentistryMedium impact

BT202254: IHCP updates FQHC and RHC encounter codes

Act
immediately
Effective date
Jan 1, 2022
Identified
Jun 19, 2026

Summary

IHCP (Indiana Medicaid) added 14 new CPT and dental procedure codes as valid FQHC and RHC encounter codes, effective retroactively to January 1, 2022. Previously denied claims with these codes will be automatically reprocessed starting August 17, 2022.

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What to do

immediately · 3 steps
01FQHC and RHC billing teams should review previously denied claims from January 1, 2022 forward that used codes 42975, 94625, 94626, D3911, D3921, D4322, D4323, D4910, D5227, D5228, D5765, D9947, D9948, or D9949.
02Monitor Remittance Advices starting August 17, 2022 for automatic reprocessing with ICNs beginning with 52 or 80.
03Stop billing deleted codes D8050 and D8060 for services after December 31, 2021.

Codes mentioned

429759462594626D3911D3921D4322D4323D4910D5227D5228D5765D9947D9948D9949D8050D8060

Original notice

BT202254: IHCP updates FQHC and RHC encounter codes
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202478: IHCP identifies discrepancy with FQHC/RHC valid encounter code listHighEffective Jul 3, 2024 · Provider BulletinBT2021113: Coverage and billing information for the 2022 annual HCPCS codes updateMediumEffective Jan 1, 2022 · Claims & BillingBT202397: IHCP announces dental coverage policy changesMediumEffective Sep 15, 2023 · Medical PolicyBT2020101: IHCP updates FQHC and RHC encounter codesMediumEffective Oct 1, 2020 · Provider BulletinBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesPulmonologySleep MedicineDentistryCode 42975Code 94625Code 94626Code D3911Code D3921Code D4322Code D4323Code D4910Code D5227Code D5228Code D5765Code D9947Code D9948Code D9949Code D8050Code D8060

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