Credentialing in Indiana

Most Indiana behavioral health is carved IN to the managed care entities. Routine outpatient BH bills to the member's MCE. But MRO (Medicaid Rehabilitation Option) and 1915(i) HCBS services (AMHH, BPHC, CMHW) are carved OUT to fee-for-service, and MRO services must be provided by an IHCP-enrolled community mental health center. Billing routine BH to FFS, or MRO to an MCE, is Indiana's classic wrong-payer denial.

IHCP Behavioral Health Services module via kb/states/in.md · checked Jul 2026

Indiana Medicaid (IHCP) providers enroll first through the IHCP Provider Healthcare Portal (CoreMMIS), then apply directly to one or more managed care entities for HIP, Hoosier Healthwise and Hoosier Care Connect. Revalidation follows the 5-year federal floor.

Indiana Medicaid IHCP Provider Healthcare Portal via kb/states/in.md · checked Jul 2026

IC 27-8-11-7 (amended 2023) is one of the strongest start-billing-sooner levers in any state: if an insurer fails to issue a credentialing determination within 15 BUSINESS DAYS of a clean completed application (the DOI-prescribed CAQH form), it must provisionally credential the provider, and once fully credentialed with an executed agreement, reimbursement is paid retroactive to the provisional date. Deficiency notices on unclean applications are due in 5 business days. Invoke the clock on every clean Indiana commercial application; the only downside risk is non-reimbursement of the provisional period if credentialing is ultimately denied.

IC 27-8-11-7 full text via kb/states/in.md · checked Jul 2026

Fully licensed clinicians (LCSW, LMHC, LMFT, LCAC) enroll and bill IHCP directly on their own NPI at 75% of the fee schedule. Services by qualified BH practitioners who are not IHCP-enrolled, including pre-independent associates, must be billed under a supervising enrolled practitioner's NPI with modifier HE, with the supervisor certifying the diagnosis and reviewing the treatment plan within 7 days of intake and at least every 90 days. Interns and practicum students bill under the supervisor with modifier HL at 50%.

IHCP Behavioral Health Services module via kb/states/in.md · checked Jul 2026

Indiana is a Counseling Compact member and went LIVE issuing and receiving privileges on June 8, 2026, the sixth operational state (with AZ, MN, OH, LA, GA). This is a genuine LPC-portability lane into Indiana, unlike the many enacted-but-not-issuing states. Indiana's independent counselor credential is the LMHC; all BH professions license through the single Behavioral Health and Human Services Licensing Board.

Counseling Compact map via kb/states/in.md · checked Jul 2026