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The Indiana Health Coverage Programs (IHCP) Professional Fee Schedule includes reimbursement information for providers that bill services using professional claims or dental claims reimbursed under the fee-for-service (FFS) delivery system*.
Welcome to Indiana Medicaid. On this site, you can learn about the different Medicaid programs and how to apply. Check out our Eligibility Guide to learn about eligibility for certain programs and see if you may qualify. Cost-Share Restart begins July 1, for HIP, CHIP and MEDWorks members.
IMPORTANT NOTICE: Before you can view the IHCP Fee Schedules, you must accept the following agreement. If you accept, you will be sent to the fee schedule pages. If you do not accept, you will be returned to the indianamedicaid.com home page. LICENSE FOR USE OF "Physicians' CURRENT PROCEDURAL TERMINOLOGY", FOURTH EDITION ("CPT")
Consult the Professional Fee Schedule, accessible from the IHCP Fee Schedules page at in.gov/medicaid/providers for coverage information. The 2022 annual HCPCS, CPT, and CDT codes will be added to the claim-processing system.
Whether you're new to Medicaid or have been a provider for years, this section is designed to help answer your billing questions. Find links to provider code sets, fee schedules and more.
The procedure codes listed in Table 1 may be reported to the IHCP on outpatient claims for dates of service (DOS) on or after Jan. 1, 2022. The Outpatient Fee Schedule will be updated to reflect this information. This fee schedule can be accessed from the IHCP Fee Schedules page at in.gov/medicaid/providers.
Through the Indiana Health Coverage Programs (IHCP) secure and easy-to-use internet portal, healthcare providers can: Submit claims; Check on the status of their claims; Inquire on a patient's eligibility; View their Remittance Advices; Managed Care Entities can: Enroll, disenroll, and update primary medical providers; Review their encounter claims
the Indiana Medicaid physician fee schedule rate for Current Procedural Terminology (CPT) code 99203. Except as otherwise noted in the plan, state -developed fee schedule rates are the same for governmental and private physicians. All rates are published on the agency’s website at
For medical supplies provided on or after February 1, 2021, the Medicaid allowable amount is the Medicaid fee schedule amount in effect on January 31, 2021. If this amount is not available, the Medicaid allowable shall be: (1) The Indiana Medicare fee schedule amount adjusted by a multiplier of eight-tenths (0.8), if available. If this
– A statewide coordinated care program for Indiana’s Medicaid enrollees who are 60 years of age or older, and eligible for Medicaid on the basis of age, blindness, or disability and have limited income and resources. Eligibility is determined by the state of Indiana’s FSSA Division of Family Resources (DFR).