Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2; IC 12-15-21-3

Affected: IC 12-13-7-3; IC 12-15

Sec. 6. (a) Medicaid reimbursement is available for the following sonography procedures:

1. (1) Sonography exams performed during pregnancy when warranted by one (1) or more of the following conditions:

   1. (A) Early diagnosis of ectopic or molar pregnancy.
   2. (B) Placental localization associated with abnormal bleeding.
   3. (C) Fetal postmaturity syndrome.
   4. (D) Suspected multiple births.
   5. (E) Suspected congenital anomaly.
   6. (F) Polyhydramnios or oligohydramnios.

   7. (G) Fetal age determination if necessitated by:

      1. (i) discrepancy in size versus fetal age; or
      2. (ii) lack of fetal growth or suspected fetal death.
   8. (H) Guide for amniocentesis.
   9. (I) Suspected uterine and pelvic abnormality.
   10. (J) Determination of fetal position.
   11. (K) Evaluation of cervix for risk of preterm loss or birth.
2. (2) Venous Doppler exams for blood flow.
3. (3) Diagnostic exams of soft tissues or organs.
4. (4) Echocardiograms.
5. (5) Other sonography exams as determined by the office.

(b) Reimbursement is available for sonography for fetal age determination prior to therapeutic abortions when the age of the fetus cannot be determined by the patient's history and physical examination and the information is essential for the selection of the abortion method.

(Office of the Secretary of Family and Social Services; 405 IAC 5-27-6; filed Jul 25, 1997, 4:00 p.m.: 20 IR 3352; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; filed Sep 11, 2019, 9:52 a.m.: 20191009-IR-405180375FRA; readopted filed Nov 13, 2019, 11:54 a.m.: 20191211-IR-405190487RFA; readopted filed May 30, 2023, 11:54 a.m.: 20230628-IR-405230292RFA)