Indiana FSSA Medicaid · October 24, 2026 · Primary source
BT2026174
Summary
The Indiana Health Coverage Programs issued Bulletin BT2026174 on October 20, 2026, providing detailed billing and operational guidance for assertive community treatment services delivered by certified community behavioral health clinics participating in Indiana's CCBHC Medicaid Demonstration Program. The bulletin, building on earlier guidance in BT2025136 that took effect February 1, 2026, specifies ACT team composition requirements, eligibility criteria for individuals served (adults over 18 with serious mental illness), prior authorization and level-of-need package rules, and required procedure codes including H0039 and the V4 modifier in place of Q2. It also addresses documentation requirements for interns and nonenrolled practitioners billing under a supervising NPI.
What this may mean
CCBHCs providing ACT services in Indiana must use the V4 modifier on all ACT team service lines and submit claims with the T1040 encounter code, with at least one triggerable service from the CCBHC encounter code list to generate a prospective payment system payment. H0039 is designated as a nontriggerable code that does not generate a PPS payment, and use of the HL or HE modifier for intern-rendered services is prohibited, requiring that intern identity be documented in the patient chart instead.
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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