MedicaidPrior AuthHigh impact
BT202031: IHCP temporarily removes prior authorization for certain DME or HME supplies and services
Indiana Medicaid (IHCP)·IN · Pulmonology, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Apr 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) is temporarily removing prior authorization requirements for specific respiratory services and DME/HME repairs and replacements during the COVID-19 public health emergency, effective April 1, 2020. Ventilators and BiPAP devices still require prior authorization.
Action Required
Immediately: Update billing system to remove prior authorization requirements for the listed respiratory codes and DME/HME repairs for Indiana Medicaid patients. Use modifiers RA (repair/replacement) and RB (part replacement) for DME repairs. Use K0739 for labor costs. Maintain documentation for medical necessity. Continue requiring prior auth for ventilators and BiPAP devices.