The Indiana Medicaid fee schedule shows the reimbursement rates that Indiana Health Coverage Programs (IHCP) uses for covered services. Providers and billing teams rely on these schedules to verify procedure code payments before submitting claims and understand how Medicaid reimbursement is calculated.
Indiana publishes separate fee schedules for different service categories, with updates released on different timelines. This guide explains what information is included, how to look up a rate, and why the listed amount may not always match the final payment.
1. What Is the Indiana Medicaid Fee Schedule?
The Indiana Medicaid fee schedule, published by Indiana Health Coverage Programs (IHCP), lists reimbursement amounts associated with covered procedure codes billed under Indiana Medicaid.
IHCP publishes two main schedules: the Professional Fee Schedule and the Outpatient Fee Schedule, each covering different service types and billing situations.
Indiana published preview rate files for 2026, effective for dates of service on and after January 1, 2026.
Updated categories include Physician Services, Durable Medical Equipment (DME) and Medical Supplies, Emergency Medical Services (EMS), and Nonemergency Medical Transportation (NEMT).
2. What Information Is on the Indiana Medicaid Fee Schedule?
Not every line on the Indiana Medicaid fee schedule is just a dollar figure. The Professional Fee Schedule covers services billed on professional or dental claims.
For each procedure code, it provides reimbursement amounts along with information such as noncovered services, prior authorization requirements, and code-specific limits.
Professional Fee Schedule
The Professional Fee Schedule covers services billed on professional or dental claims.
For each procedure code, it lists the reimbursement amount, whether the service is noncovered, and flags such as prior authorization requirements or age and unit limits.
It updates the second Tuesday of every month, with the underlying data current as of the Sunday before.
- Procedure code reimbursement amounts
- Coverage indicators and prior authorization requirements
- Age or unit limits for applicable codes
- Search options by code, code range, or description
- Schedule update information
>>> Read more: Does Medicaid Cover Braces in Indiana? When Treatment May Be Approved
Outpatient Fee Schedule
The Outpatient Fee Schedule covers rates for outpatient hospital services and ambulatory surgical centers (ASCs), billed under the fee-for-service delivery system. It includes reimbursement information tied to both procedure codes and revenue codes used for outpatient billing.
IHCP publishes a companion Q&A document alongside the schedule to walk providers through common questions about how rates apply.
- Outpatient hospital rates for services delivered without an overnight admission
- Ambulatory surgical center rates for procedures performed at standalone surgical facilities
- Reimbursement tied to a combination of procedure codes and revenue codes, since outpatient billing often needs both to identify the service and setting
- Supplementary guidance available in IHCP’s Outpatient Fee Schedule Q&A
- Beginning in 2026, the Outpatient Fee Schedule follows a biannual update cycle instead of the previous monthly schedule.
3. What Changed in the Indiana Medicaid Fee Schedule for 2026?
Indiana Medicaid fee schedule updates vary depending on the service category, so providers should review the schedule that applies to their claims rather than assume all services changed the same way.
For 2026, IHCP updated rates for categories including:
- Physician Services
- Durable Medical Equipment (DME) and Medical Supplies
- Emergency Medical Services (EMS)
- Nonemergency Medical Transportation (NEMT)
Rate changes are not identical across all procedure codes. Providers should verify the specific code and effective date before billing services delivered after the update.
>>> Read more: Medicaid Income Limits Indiana: Know The Maximum Income To Qualify
4. How to Find a Rate on the Indiana Medicaid Fee Schedule
IHCP allows providers to search rates online by procedure code, code range, or description. Files can also be downloaded for reference or use in billing systems. Follow these four steps:
- Go to the IHCP Fee Schedules page
- Choose Professional Fee Schedule or Outpatient Fee Schedule
- Accept the user agreement (Professional Fee Schedule only)
- Search by procedure code, code range, or description, or download the full file
5. Does the Listed Indiana Medicaid Rate Equal the Final Payment?
No. The Indiana Medicaid fee schedule rate is a reference amount, not always the final payment a provider receives.
Several factors between the published rate and the actual payout can change the final amount.
Fee-for-Service vs. Managed Care
Not always. The published fee schedule reflects fee-for-service rates, which apply directly to claims billed outside a managed care plan.
For managed care claims, the published rate may serve as a minimum reference point rather than the exact contracted payment amount. Providers should confirm rates directly with the specific managed care plan.
Why the Final Payment Can Differ
Managed care organizations can negotiate rates above the published fee-for-service amount, and some claims involve adjustments for coordination of benefits, deductibles, or other payer rules that change the final reimbursement.
Providers who bill managed care claims should confirm the contracted rate with the specific plan rather than relying solely on the published fee schedule.
6. Reduce Monthly Phone Bill up to $0 through Medicaid & Lifeline Program
You came here to check a fee schedule number. If that number matters to you as a beneficiary and not as a billing provider, one more number is worth a look: your monthly phone bill.
The Lifeline program is a federal benefit that lowers that bill directly by up to $9.25 a month for most households or up to $34.25 a month on qualifying Tribal land.
Your Indiana Medicaid enrollment already clears the main hurdle. A few other paths work too:
- SNAP, SSI, Section 8, or Veterans Pension enrollment
- Household income at or below 135% of the federal poverty guidelines
The rule to remember: one discount per household, not transferable to anyone else.
The discount itself comes from the federal government, but a participating Eligible Telecommunications Carrier is what puts it to use. Cintex Wireless serves in that role, pairing the standard monthly credit with a free or discounted device for those who qualify.
After merging into AirTalk Wireless, applicants are now offered an improved sign-up experience along with a larger range of devices to pick from.
Just as the fee schedule helps you plan around healthcare costs, Lifeline helps you plan around a different kind of expense, keeping you connected with data, talk and text, international calling, and none of the usual contracts, credit checks, or activation fees.
IMPORTANT: The government does not subsidize devices. Lifeline programs cover basic service costs only. Free or discounted devices, upgrade plans, or top-ups are exclusive benefits provided by AirTalk Wireless and Cintex Wireless as part of the promotional offers. Terms and conditions apply. Limited-time promotion—offers vary by state, stock availability, and eligibility.
7. Frequently Asked Questions
Q1. What are the billing guidelines for Indiana Medicaid members?
The full billing policy is published through IHCP’s provider reference materials, covering claim submission rules, coding requirements, and prior authorization procedures. Providers should consult those references directly for complete guidance beyond rate lookups.
Q2. Does the Indiana Medicaid fee schedule show what patients pay?
No. The fee schedule shows provider reimbursement amounts, not the cost a Medicaid member pays. Patient costs depend on Medicaid coverage rules, eligibility, and the specific service received.
Q3. What is the Medicaid fee schedule in Alabama?
Each state publishes its own fee schedule independently, and Alabama’s rates differ from Indiana’s. Check Alabama’s Medicaid agency directly for that state’s specific reimbursement figures.
Q4. What are the Indiana Medicaid guidelines for 2026?
The most significant 2026 update comes from IHCP Bulletin BT2025156, which revised rates across four categories: Physician Services, DME and Medical Supplies, EMS, and NEMT, effective January 1, 2026.
Conclusion
The Indiana Medicaid fee schedule comes down to two published lists, Professional and Outpatient, both searchable directly through IHCP.
Bookmark the portal and check for monthly or biannual updates depending on which schedule applies to your billing. A few minutes spent confirming a rate before submitting a claim can save a lot of correction work later.
