MedicaidBilling CodesHigh impact
BT202214: OMPP is making changes to billing and reimbursement for TBI facility services
Indiana Medicaid (IHCP)·IN · Neurology, PM&R (Physical Medicine & Rehab)·Claims & Billing
Effective date
Feb 1, 2022
We identified it
Jun 19, 2026
Summary
OMPP is updating billing and reimbursement for traumatic brain injury (TBI) facility services effective January 1, 2022, with claims impacted starting February 1, 2022. Providers must use exact HCPCS code H2013 with specific modifiers based on member billing levels as listed in prior authorization letters, and per diem rates have been updated with 10 different rate tiers ranging from $314 to $624.
Action Required
Immediately for claims with dates of service February 1, 2022 and after: Billing team must use exact procedure code H2013 with the specific modifier combination (UB, UA, U9, U8, U6, U5, U4, U3, U2, or U1) listed on each member's prior authorization letter. Update billing system with new per diem rates ranging from $314-$624 based on total domain scores. Claims submitted with incorrect code-modifier combinations will be denied for payment.