Ordering, Prescribing, or Referring Providers

For Medicaid to reimburse for services or medical supplies resulting from a practitioner's order, prescription, or referral, the ordering, prescribing, or referring (OPR) provider must be enrolled in Medicaid. OPR providers do not bill the Indiana Health Coverage Programs (IHCP) for services rendered but may order, prescribe, or refer services and supplies for IHCP members. Enrolling as an OPR provider is appropriate for providers who:

  • May occasionally see an individual who is an IHCP member who needs additional services or supplies that will be covered by the Medicaid program
  • Do not want to be enrolled as another IHCP provider type
  • Do not plan to submit claims to the IHCP for payment of services rendered

Participate in the IHCP as an OPR Provider

Interested providers and existing OPR providers should see Participating as an OPR Provider on this site for detailed information about enrollment and other transactions.

Directory of OPR Providers

IHCP providers that render services must verify IHCP enrollment of the ordering, prescribing, or referring provider before service or supplies are rendered. A comprehensive OPR Provider Search tool is under development. Until this tool is available, providers must use a two-step process to verify IHCP enrollment of OPR practitioners.

Providers can use the IHCP Provider Search to identify most IHCP-enrolled providers; however, this search does not include OPR-only providers. Providers can refer to the OPR Providers list to see whether a practitioner is enrolled with the IHCP as an OPR-only provider for dates of service on or after February 13, 2017. This list will be updated weekly until the comprehensive OPR search tool is available.