IHCP Update: Published 7/28

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at in.gov/medicaid/providers on July 28, 2020 (unless alternate date is noted).

​Banner Page
BR202030

• IHCP updates personal care services procedure codes that require EVV

Provider Reference Modules
Anesthesia Services

• Updated the Anesthesia Procedure Codes and Modifiers section to remove the AA modifier requirement
• Updated the Anesthesiologist Assistant Requirements section and added a footnote clarifying the usage of the QX modifier
• Updated the Medical Direction Requirements section, including:
• Added information about claims denying if multiple providers bill the same anesthesia service code for the same member on the same date, unless the appropriate medical direction modifier is used
• Clarified that claim details billed with the QY modifier will deny

Hospice Services (see the module for a complete list of updates)

• Changed CMCS references to DXC and updated contact information where applicable
• Updated the Hospice Core and Noncore Services section to provide clarification around nonhospice versus hospice physician services
• Updated the Hospice Providers Located Outside Indiana section
• Added a note about the removal of hospital lock-in requirements in the Right Choices Program (Lock-In) Members section
• Added Emergency Services Only Coverage with Pregnancy Coverage (Package B) to the list in the Programs and Aid Categories Ineligible for the IHCP Hospice Benefit section
• Updated Table 5 – Indiana Health Coverage Programs Prior Authorization Request Form Fields for Hospice Requests
• Clarified information and updated the timely filing limit in the Special Batch Claims section
• Clarified information about hospice per diem rates in the introductory text for Section 6: Billing and Reimbursement and added a note about where to find the current rates
• Added a note in the Revenue Codes section to clarify usage of revenue codes 651 and 652
• Updated the Admission to a Nursing Facility for Treatment of Nonterminal Conditions section and Scenario 1 subsection to include cases where the member is admitted directly to a nursing facility for recovery from a nonterminal condition, without first being hospitalized

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

• All codes were reviewed

Hospice Services Codes

• All codes were reviewed

Service Codes That Require Electronic Visit Verification

• Updated the following table: Procedure Codes and Modifiers for Personal Care Services That Require EVV
• For details, see BR202029 and BR202030

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