Indiana
highIN IHCP MAX FEE Schedules
Run Date and Time
Mar 03, 2026
22s
Run Metrics
Fee Schedule Impacts
Run summary
Run: 956ccd99-d94a-4455-a68f-2004dc7406c1 Status: ok Started: 2026-03-03T03:44:48.503090+00:00 Finished: 2026-03-03T03:45:11.495483+00:00 Source: Indiana Health Coverage Programs Hub: IN_IHCP_MAX_FEE_SCHEDULES IMPORTANT NEW_DOC (Current/Upcoming) - 5 - Effective 2025-08-01 - The document introduces an updated outpatient fee schedule for IHCP, with specific updates to code allowances linked to revenue codes, effective August 1, 2025. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient-Fee-Schedule-2025-08.xlsx - Effective 2025-10-01 - The document introduces an outpatient fee schedule update for the Indiana Health Coverage Programs (IHCP), with specific updates to code allowances and revenue codes effective October 1, 2025. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient-Fee-Schedule-2025-10.xlsx - Effective 2025-12-01 - The document introduces an updated outpatient fee schedule for the Indiana Health Coverage Programs (IHCP), with specific updates to code allowances linked to various revenue codes. Notably, tabs 3, 7, and 9 have been updated to reflect new code allowances and updates, effective December 1, 2025. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient-Fee-Schedule-2025-12.xlsx - Effective 2026-01-01 - The document introduces updates to the outpatient fee schedule for IHCP, including code updates and new codes allowed with specific revenue codes. Notably, tabs 3 and 9 have been updated with new codes effective from January 1, 2026, and December 1, 2025, respectively. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient-Fee-Schedule-2026-01.xlsx - Effective 2026-01-01 - The document outlines the Indiana Health Coverage Programs' (IHCP) review of the 2026 HCPCS code update, effective January 1, 2026. It includes coverage details for specific medical items and procedures. URL: https://www.in.gov/medicaid/providers/files/bulletins/BT2025188.pdf HISTORICAL DISCOVERIES NEW_DOC (Historical) - 1 - Effective 2023-01-01 - The document introduces updates related to the Hospital Assessment Fee (HAF) adjustment factors for outpatient and inpatient rates, effective as of January 1, 2023. It references specific IHCP bulletins for detailed information on these adjustments. (LLM: medium) URL: https://www.in.gov/medicaid/providers/files/modules/hospital-assessment-fee.pdf OTHER NEW_DOC (Unknown date) - 4 - The document provides guidance on billing procedure codes with appropriate revenue codes, noting deviations from national guidelines for specific codes. It also addresses the organization of anesthesia codes in the fee schedule and confirms monthly updates to the schedule. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient%20Fee%20Schedule%20QandA.pdf - The document is a professional fee schedule updated on February 10, 2026, with changes made after January 27, 2026, not displayed. It includes various procedures marked as non-covered services with a rate of 0.00. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Professional%20Fee%20Schedule.xlsx - The document includes updates to the outpatient fee schedule for IHCP, with specific changes to code updates in Tab 3 and new codes allowed with revenue code 636 as of August 1, 2025. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient-Fee-Schedule-2025-09.xlsx - The document includes updates to the outpatient fee schedule for IHCP, with specific code updates noted for several tabs, effective from 2025-08-01 to 2025-11-01. It also details specific orthotic codes and descriptions. URL: https://provider.indianamedicaid.com/ihcp/Publications/MaxFee/Outpatient-Fee-Schedule-2025-11.xlsx
High Impact (1)
BT2025188.pdf
The document outlines the Indiana Health Coverage Programs' (IHCP) review of the 2026 HCPCS code update, effective January 1, 2026. It includes coverage details for specific medical items and procedures.
Highlights
- •IHCP bulletin for 2026 HCPCS update.
- •Effective for services on or after January 1, 2026.
- •Coverage details for specific codes like A4295, A4296, A4297.
- •Awaiting CMS fee schedule final posting.
Reason
The document includes new coverage and billing guidelines effective soon, impacting reimbursement.
Watch items
Medium Impact (9)
Outpatient-Fee-Schedule-2025-11.xlsx
The document includes updates to the outpatient fee schedule for IHCP, with specific code updates noted for several tabs, effective from 2025-08-01 to 2025-11-01. It also details specific orthotic codes and descriptions.
Highlights
- •Outpatient fee schedule updates for IHCP.
- •Code updates effective from 2025-08-01 to 2025-11-01.
- •Includes specific orthotic codes L0458 and L0460.
- •Tabs with updated codes are highlighted in green.
Reason
The document contains upcoming code updates, but lacks specific rate changes or immediate effective dates.
Watch items
Outpatient-Fee-Schedule-2025-09.xlsx
The document includes updates to the outpatient fee schedule for IHCP, with specific changes to code updates in Tab 3 and new codes allowed with revenue code 636 as of August 1, 2025.
Highlights
- •Outpatient fee schedule for IHCP updated.
- •Tab 3 reflects code updates as of 2025-08-01.
- •New codes allowed with revenue code 636 as of 2025-08-01.
Reason
The updates are relevant but not immediately urgent, with changes effective in the future.
Watch items
hospital-assessment-fee.pdf
The document introduces updates related to the Hospital Assessment Fee (HAF) adjustment factors for outpatient and inpatient rates, effective as of January 1, 2023. It references specific IHCP bulletins for detailed information on these adjustments.
Highlights
- •HAF adjustment factors for outpatient and inpatient rates updated.
- •Effective date for policies: January 1, 2023.
- •Referenced IHCP bulletins: BT2024106, BT202389.
- •Adjustment reason code (ARC) 169 used for increased payments.
Reason
The document references updates to adjustment factors, but the effective date is not imminent, and the changes are not fully detailed in the evidence.
Watch items
Professional Fee Schedule.xlsx
The document is a professional fee schedule updated on February 10, 2026, with changes made after January 27, 2026, not displayed. It includes various procedures marked as non-covered services with a rate of 0.00.
Highlights
- •Document updated on February 10, 2026.
- •Changes after January 27, 2026, not displayed.
- •Includes non-covered services with 0.00 rate.
- •Procedures listed with CMS add and term dates.
Reason
The document is current but lacks specific rate changes impacting reimbursement.
Outpatient-Fee-Schedule-2025-10.xlsx
The document introduces an outpatient fee schedule update for the Indiana Health Coverage Programs (IHCP), with specific updates to code allowances and revenue codes effective October 1, 2025.
Highlights
- •Outpatient fee schedule update for IHCP.
- •Tab 3 updated for code updates effective 2025-10-01.
- •New codes allowed with revenue code 636 as of 2025-08-01.
Reason
The updates are relevant but not immediately effective, with changes scheduled for October 2025.
Watch items
Outpatient-Fee-Schedule-2025-08.xlsx
The document introduces an updated outpatient fee schedule for IHCP, with specific updates to code allowances linked to revenue codes, effective August 1, 2025.
Highlights
- •New outpatient fee schedule for IHCP.
- •Updates to codes linked with revenue code 636.
- •Effective date: August 1, 2025.
Reason
The changes are relevant but not immediately urgent, with an effective date in the future.
Watch items
Outpatient Fee Schedule QandA.pdf
The document provides guidance on billing procedure codes with appropriate revenue codes, noting deviations from national guidelines for specific codes. It also addresses the organization of anesthesia codes in the fee schedule and confirms monthly updates to the schedule.
Highlights
- •Guidance on billing procedure codes with revenue codes.
- •Deviations for revenue codes 260, 274, 636, 724, 920, 929, 940.
- •Anesthesia codes 00100–01999 sorting issue noted.
- •Outpatient fee schedule updated monthly.
Reason
The document provides billing guidance and mentions monthly updates, but lacks specific rate changes or effective dates.
Outpatient-Fee-Schedule-2026-01.xlsx
The document introduces updates to the outpatient fee schedule for IHCP, including code updates and new codes allowed with specific revenue codes. Notably, tabs 3 and 9 have been updated with new codes effective from January 1, 2026, and December 1, 2025, respectively.
Highlights
- •Outpatient fee schedule updates for IHCP.
- •Tab 3 updated with code updates effective 2026-01-01.
- •Tab 9 updated with new codes for revenue code 636 effective 2025-12-01.
- •New codes allowed with revenue code 274 updated on 2025-12-01.
Reason
The updates are relevant but not immediately effective, with future effective dates.
Watch items
Outpatient-Fee-Schedule-2025-12.xlsx
The document introduces an updated outpatient fee schedule for the Indiana Health Coverage Programs (IHCP), with specific updates to code allowances linked to various revenue codes. Notably, tabs 3, 7, and 9 have been updated to reflect new code allowances and updates, effective December 1, 2025.
Highlights
- •Updated outpatient fee schedule for IHCP.
- •New code allowances for revenue codes 274 and 636.
- •Effective date for updates: December 1, 2025.
- •Tabs 3, 7, and 9 have specific updates.
Reason
The updates are relevant but not immediately effective, with changes scheduled for December 2025.
Watch items
Low Impact (0)
No documents in this severity group.