MedicaidAdministrativeHigh impact
BT202015: IHCP to implement third-party liability cost avoidance on prenatal care claims
Indiana Medicaid (IHCP)·IN · OB-GYN, Family Medicine·Provider Bulletin
Effective date
May 1, 2020
We identified it
Jun 19, 2026
Summary
Starting May 1, 2020, Indiana Medicaid (IHCP) will require providers to bill third-party liability (TPL) resources first before billing Medicaid for prenatal care services. Prenatal care will no longer be exempt from TPL cost avoidance requirements.
Action Required
Before May 1, 2020: Billing team must update workflows to bill third-party liability insurance first for all prenatal care claims before submitting to Indiana Medicaid. Update billing system to remove prenatal care diagnosis codes from TPL bypass list. Verify patient insurance coverage and bill primary insurance before IHCP for all prenatal services.