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Indiana Medicaid (IHCP)Medicaid · Billing Codes · Claims & Billing · INMedium impact

BT202027: April 2020 quarterly HCPCS code updates announced

Effective date
Apr 1, 2020
Identified
Jun 19, 2026

Summary

The IHCP reviewed the CMS quarterly HCPCS code updates effective April 1, 2020 and set coverage and billing guidelines for the new codes. Seven new codes are covered: 87635, C9053, C9056, C9057, C9058, U0001 and U0002. The remaining new codes are Noncovered, meaning the IHCP does not cover them for any programs.

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What to do

Action · 6 steps
01Already effective April 1, 2020: Billing team should check current applicability of these codes before billing them.
02Covered codes may be billed for dates of service on or after April 1, 2020.
03Claims for C9053, C9056, C9057 and C9058 require an NDC.
04C9053, C9056 and C9058 may be billed with revenue code 636 for separate reimbursement, as appropriate, for dates of service on or after April 1, 2020.
05For 87635, effective for dates of service on or after March 13, 2020 for commercial labs, the IHCP pays 30% of billed charges on a professional claim and 15% of billed charges on an institutional claim.
06U0001 is for CDC and state-run lab testing and U0002 is for commercial labs, both effective for dates of service on or after February 4, 2020 and copay exempt for all programs.

Codes mentioned

87635C9053C9056C9057C9058G1012G1013G1014G1015G1016G1017G1018G1019G2168G2169U0001U0002

Original notice

BT202027: April 2020 quarterly HCPCS code updates announced
in.gov · Always check the source before changing claims.
View original ↗

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Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesCode 87635Code C9053Code C9056Code C9057Code C9058Code G1012Code G1013Code G1014Code G1015Code G1016Code G1017Code G1018Code G1019Code G2168Code G2169Code U0001Code U0002

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