Indiana FSSA Medicaid · October 24, 2026 · Primary source
BT2026172
Summary
The Indiana Health Coverage Programs issued Bulletin BT2026172 on October 15, 2026, clarifying third-party liability billing requirements for FQHCs and rural health clinics submitting Medicaid fee-for-service claims. The bulletin specifies that TPL payment information must appear at both the claim header level and the service detail level, with detail-level amounts totaling the header amount, and that TPL dollars must be entered with the all-inclusive encounter code (T1015 or D9999), not with individual service-line procedure codes. Claims that incorrectly place TPL payments at the individual service-line detail level may result in provider recoupments.
What this may mean
FQHCs and RHCs billing Indiana Medicaid FFS claims for members with other insurance coverage must restructure their TPL submissions to attach payment amounts to the T1015 or D9999 encounter code detail rather than to individual service codes. Incorrect submission structures trigger recoupments, and paper claims must include the IHCP Third-Party Liability Special Attachment Form.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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