Healthy Indiana Plan (HIP) Consult Code Update
Anthem HIP – Effective January 1, 2010, Anthem HIP does not allow consultation codes. Providers should use new or established patient office visit codes, initial inpatient or subsequent hospital care codes, etc, in the same manner as you do for Medicare claims.
MDwise HIP – At this time the MDwise HIP plan continues to allow coverage for consultation codes. These services are reimbursed at 130 percent of the Medicaid allowable, as there is no longer a Medicare fee for these codes. MDwise has advised that they plan to discontinue coverage of consultation services on July 1, 2010. However, this is subject to change. Providers will be notified in advance of the effective date. If you are not a MDwise HIP contract provider you will need to visit the MDwise website to obtain information about changes to the plan. Visit www.mdwise.org, hover over Providers, and click on Healthy Indiana Plan to access updates and MDwise HIP Provider Newsletters and Provider Manual.
