IHCP to revise rates for select clinical laboratory services based on 2018 Medicare rates

Pursuant to Section 1903(i)(7) of the Social Security Act, Medicaid reimbursement for individual clinical laboratory procedures cannot exceed the Medicare rate of reimbursement. Therefore, in accordance with the clinical laboratory reimbursement methodology set out in 405 IAC 5-18-1 and in the approved Indiana Medicaid State Plan (Attachment 4.19B, page 1c), the Indiana Health Coverage Programs (IHCP) will adopt the 2018 Medicare rates for any clinical laboratory procedure code for which the IHCP’s current reimbursement rate exceeds the 2018 Medicare rate. These rate changes will be effective for dates of service (DOS) on or after January 1, 2018, and will be reflected on the IHCP Professional Fee Schedule at indianamedicaid.com.