IHCP Update: Published 6/25

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at in.gov/medicaid/providers on June 25, 2020 (unless alternate date is noted).

Bulletins
BT202079 – IHCP revises Hospital Assessment Fee adjustment factors for outpatient and inpatient rates
BT202078 – Pharmacy updates approved by Drug Utilization Review Board June 2020
BT202077 – IHCP announces changes to DRG grouper and inpatient hospital reimbursement rates

​Provider Reference Modules
Vision Services

• In the Corneal Tissue section, updated list of services discussed in the Surgical Services module
• Updated the Voretigene Neparvovec-rzyl (Luxturna) section to reflect current policy
• Added cross-reference to Member Eligibility and Benefit Coverage module to the Vision Benefit Limits section
• Removed information about submitting inquiries by mail in the Written Correspondence section

Electronic Data Interchange

• Changed EDI Trading Partner Agreement reference to IHCP Trading Partner Agreement

• Updated the HIPAA Standards for Electronic Transactions section to match website and clarify atypical providers

Code Tables
The following code table updates are accessible from the Code Sets page:
Telemedicine Services Codes

• Updated information regarding special billing guidance during the public health emergency

• See BT202034 and BT202037 for details

Vision Services Codes

• All codes were reviewed

Companion Guides
834 MCE Benefit Enrollment and Maintenance Transaction, Version 5.3

• Added Healthy Indiana Plan (HIP) capitation categories for 18-year-olds

Check out these resources to stay up-to-date with the most recent changes at the IHCP.