IHCP Update: Published October 19

The Indiana Health Coverage Programs posted the following important information to the provider website at in.gov/medicaid/providers on Oct. 19, 2021 (unless alternate date is noted).

​News and Announcement
FSSA hosts MLTSS webinar Nov. 2 (Oct. 18, 2021)
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• Sandata to host webinar for alternative EVV vendors
• Outpatient Fee Schedule correction for A4555 and E0766
• IHCP removes prior authorization requirement for developmental testing codes 96112 and 96113
• IHCP updates Outpatient Fee Schedule- prior authorization
• IHCP announces procedure code links to revenue code 260
• Certain procedure codes now inpatient only, no longer reimbursable in outpatient setting
• Sum of all payors added to remittance advice on FQHC/RHC professional claims

Provider Reference Modules
Injections, Vaccines and Other Physician-Administered Drugs

• Changed ISDH references to IDOH
• Changed DXC references to Gainwell
• Updated the Managed Care Carve-Outs section to add an exception for Zolgensma and a note about COVID-19 vaccination
• In the Drug Administration Fees section:
  • Added a note about COVID-19 administration codes
  • Added a note about the limit prohibiting reimbursement of both a drug administration code and a treatment room revenue code for the same date of service as being per provider
• Added the Brexanolone (Zulresso) section
• Added J5070 to the Buprenorphine section
• Added the Casimersen (Amondys 45) section
• Added the Crizanlizumab-tmca (Adakveo) section
• Added the Eptinezumab-jjmr (Vyepti) section
• Added the Leuprolide Acetate (Fensolvi) section
• Added noncovered treatments to the Nusinersen (Spinraza) section
• Updated the Onasemnogene Abeparvovec-xioi (Zolgensma) section

Code Tables
The following code table updates are accessible from the Code Sets page:
Injections, Vaccines and Other Physician-Administered Drugs Codes

• All codes were reviewed

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