medical review team (MRT)

Overview

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 of
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.