Indiana Medicaid — Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP)
| Program name | Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP) |
|---|---|
| Provider portal | https://www.in.gov/medicaid |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 180 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the Indiana Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in Indiana
The Blue Cross Blue Shield Association licensee in Indiana is Anthem Blue Cross and Blue Shield of Indiana (Elevance Health). See the Anthem (Elevance Health) payer guide for payer ID, timely filing, prior auth, and appeal procedures.
Top commercial payers in Indiana
The dominant commercial insurers operating in Indiana, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in Indiana
Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP) contracts with the following managed-care organizations to administer Medicaid benefits in Indiana. MCO contracts dictate claims routing, prior-auth workflows, and appeal deadlines — route each claim by the member's MCO assignment, not the state FFS payer ID.
Medicare contractor and active LCDs in Indiana
Wisconsin Physicians Service Insurance Corporation is the Medicare A/B MAC for Indiana: Part A and Part B fee-for-service claims from Indiana go to it, and its Local Coverage Determinations decide local medical necessity. Durable medical equipment and supply claims go to CGS Administrators, LLC as the DME MAC. Home health and hospice claims are processed by Palmetto GBA. In the current Medicare Coverage Database export, 183 active LCDs from these contractors apply to Indiana claims.
- Wisconsin Physicians Service Insurance Corporation
A/B MAC (Part A and Part B claims)
- CGS Administrators, LLC
DME MAC (durable medical equipment and supplies)
- Palmetto GBA
Home health and hospice MAC
Selected active Wisconsin Physicians Service Insurance Corporation policies for Indiana
A selection, not the full list: policies with measured search demand come first, then those on topics that more contractors publish LCDs for.
- L37228 Wound Care
- L38841 Facet Joint Interventions for Pain Management
- L39054 Epidural Steroid Injections for Pain Management
- L34645 Urine Drug Testing
- L39051 Cosmetic and Reconstructive Surgery
- L35498 Removal of Benign Skin Lesions
- L36839 Polysomnography and Other Sleep Studies
- L34596 Immunizations
- L34614 Colonoscopy and Sigmoidoscopy-Diagnostic
- L35751 Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
- L35755 Non-Invasive Abdominal / Visceral Vascular Studies
- L34594 Nerve Conduction Studies and Electromyography
Equipment, home health and hospice policies that apply in Indiana
- L33822 Glucose Monitors
- L33789 Power Mobility Devices
- L33318 Knee Orthoses
- L33686 Ankle-Foot/Knee-Ankle-Foot Orthosis
- L33718 Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
- L34544 Hospice - Liver Disease
- L34547 Hospice - Neurological Conditions
- L34548 Hospice Cardiopulmonary Conditions
Steps to confirm which LCD governs a claim · Every active LCD by contractor
State-specific regulations affecting Indiana billing
- Indiana Code §27-8-10.1 (Out-of-Network Health Care Services — balance billing, as amended 2020)
- Indiana Code §27-8-5.7 (prompt pay — 30 days electronic clean claim)
- Indiana Code §16-21-9 (hospital financial assistance)
Provider licensing & enrollment in Indiana
Providers enroll via IHCP Provider Healthcare Portal (Gainwell). All MCE participation requires IHCP enrollment first.
Major health systems headquartered in Indiana
| Health system | Headquarters |
|---|---|
| IU Health (Indiana University Health) | Indianapolis, IN |
| Community Health Network | Indianapolis, IN |
| Franciscan Health Indiana | Mishawaka, IN |
| Parkview Health | Fort Wayne, IN |
| Ascension St. Vincent Indiana | Indianapolis, IN |
Frequently asked questions — Indiana billing
What is the Indiana Medicaid program called?
Indiana's Medicaid program is known as Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP). Providers enroll and manage claims through the provider portal at https://www.in.gov/medicaid.
What is the Indiana Medicaid timely filing limit?
Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP) requires initial claims to be filed within 180 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; Indiana's 180-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does Indiana Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in Indiana?
The dominant commercial payers in Indiana include Anthem (Elevance Health), UnitedHealthcare, Aetna, Cigna, Humana, along with the BCBS licensee Anthem Blue Cross and Blue Shield of Indiana (Elevance Health). Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in Indiana?
Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP) contracts with 5 Medicaid MCOs tracked in the QuickIntell registry, including Anthem (Elevance Health), CareSource, Centene, Molina Healthcare, UnitedHealthcare. MCO contracts determine claims routing and appeal deadlines — route each claim by the member's MCO assignment, not by the FFS payer ID.
What state-specific billing regulations apply in Indiana?
Indiana has 3 tracked state-level statutes that affect medical billing and RCM: Indiana Code §27-8-10.1 (Out-of-Network Health Care Services — balance billing, as amended 2020); Indiana Code §27-8-5.7 (prompt pay — 30 days electronic clean claim); Indiana Code §16-21-9 (hospital financial assistance). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in Indiana with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to Indiana Health Coverage Programs (IHCP / Hoosier Healthwise / Hoosier Care Connect / HIP) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from Indiana Medicaid and the member ID card before submission.