medical review team (MRT)
The Medical Review Team (MRT) determines an applicant's
eligibility for Indiana Medicaid based on a disability.
Determinations are based on medical information requested by the
MRT. Providers are reimbursed for MRT services, such as medical
exams, medical tests, or record copying, in accordance with an
established fee schedule.
The Division of Family Resources (DFR) is responsible for
determining initial and continuing eligibility for Medicaid
disability. To meet the disability requirement, a person must have
a significant impairment that is expected to last a minimum
12 months. The MRT makes this determination and notifies the DFR
of its decision.
Indiana Health Coverage Programs (IHCP) enrollment is required
to participate in the MRT program. Providers must be enrolled in
the MRT program to submit claims for payment of MRT services.
Nonlicensed providers are eligible to enroll as providers under the
MRT program for reimbursement of medical records copying only. To
complete the enrollment process for the MRT program, prospective
providers must complete an enrollment application and designate
"Yes" in the section of the form pertaining to the MRT program.
For more information, see the IHCP Provider Reference
Modules or BT200514 and BT200620.