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Provider Billing Reminder for Hospitals, LTC, and SUPR Providers

Date: 11/12/25

This notice applies to hospitals, Long Term Care (LTC), and Substance Use Prevention and Recovery (SUPR) providers who deliver services for Meridian Medicaid Plan and YouthCare members.

For all claims received on or after November 20, 2025, Meridian will validate claims to ensure compliance with IAMHP Billing Guidelines.

Billing for inpatient or residential services

  • Value codes 80 and 81 must be reported to represent any covered or non-covered days. If an inpatient or residential claim fails to report the value code, it will be denied with EXbd – MISSING VALUE CODE 80 AND/OR 81*
  • If a provider bills an admit through discharge claim (claim frequency equal to 1) or final interim billing (claim frequency equal to 4) and sets the discharge state to “30” (still a patient), the claim will be denied with EX8d – DENY: DISCHARGE STATUS INVALID FOR TYPE OF BILL***
  • HFS does not allow patient discharge status equal to “09.” The claim will be denied with EX55 – DENY: ILLOGICAL PATIENT STATUS HFS DOES NOT ACCEPT 09****
  • Interim billing reminders for per diem reimbursed services when interim billing rules are allowed (denoted by claim frequency equal to 2 or 3):
    • Please note that the patient discharge status code must be equal to “30” (still a patient) when billing claim frequency 2 or 3. If a claim fails this validation, it will be denied with EXGo – INTERIM FACILITY CLAIMS BILLED WITHOUT DISCHARGE STATUS CODE 30**
    • If the claim frequency billed is 2, the statement through date must equal the end of a calendar month and cannot crossover months. If the claim fails this validation, it will be denied with EX7N – BILL FREQ TYPE CODE 2 CANNOT CROSS MONTHS******
    • If the claim frequency billed is 3, the statement from and statement through dates must be a full month and cannot crossover months. If the claim fails this validation, it will be denied with EX6M – BILL FREQ TYPE CODE 3 MUST BE FULL MONTH AND CANNOT CROSSOVER MONTHS*****

* CARC 16/RARC M49
**CARC 16/RARC N318
***CARC 16/RARC N50
****CARC 16/RARC MA43
*****CARC 16/RARC EX6M
******CARC 16/RARC EX7N

For questions please contact Provider Services at 866-606-3700 or reach out to your Provider Engagement contact. For more information on billing requirements download the IAMHP Billing Guide (PDF).