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MedicaidReimbursementHigh impact

BT202106: IHCP to update rates for certain DME and medical supply items effective February 1, 2021

Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Pulmonology, Wound Care·Provider Bulletin
Effective date
Feb 1, 2021
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Medicaid (IHCP) is updating reimbursement rates and rental periods for specific DME and medical supply HCPCS codes effective February 1, 2021, implementing 21st Century Cures Act requirements. The changes include new capped rental periods (6 months for power wheelchairs, 10 months for other DME), maximum fee pricing for previously manual-priced items, and rental-only reimbursement for home ventilator E0467.

Action Required

Action needed
By February 1, 2021: Billing team must update DME billing system with new reimbursement rates for all listed HCPCS codes and implement new capped rental periods (6 months for power wheelchairs, 10 months for other DME items). Stop billing E0467 home ventilator as purchase - rental payments only. Remove pricing attachment requirements for codes in Table 5. Update fee schedules from IHCP website and modify billing software to reflect new maximum fees and rental periods.

Affected Billing Codes

A5514
A7007
A7009
A7017
E0100
E0105
E0110
E0111
E0112
E0113
E0114
E0116
E0130
E0135
E0140
E0141
E0143
E0144
E0147
E0148
E0149
E0160
E0161
E0163
E0165
E0167
E0168
E0170
E0181
E0184
E0185
E0186
E0188
E0189
E0196
E0197
E0199
E0202
E0210
E0235
E0250
E0251
E0255
E0256
E0260
E0261
E0265
E0266
E0277
E0290
E0291
E0467