MedicaidCoverageMedium impact
BT202674: FSSA clarifies Behavioral Support Services for FS and CIH waivers
Indiana Medicaid (IHCP)·IN · Psychiatry·Specialty Services
Effective date
May 14, 2026
We identified it
Jun 18, 2026
Summary
FSSA has clarified utilization limits for Behavioral Support Services (BSS) under Indiana Medicaid Home- and Community-Based Services (HCBS) Family Supports and Community Integration and Habilitation waivers. The policy establishes specific hourly limits and guidelines for consultation (3 hours/month max), functional behavioral assessment (20 hours over 2 months max), and comprehensive services (12 hours/month average), with a total cap of 144 hours per plan year.
Action Required
Immediately: Billing team must update prior authorization tracking to ensure BSS services comply with new limits: consultation max 3 hours/month, FBA max 20 hours over 2 concurrent months, comprehensive services average 12 hours/month with 144-hour annual cap. Coordinate with case managers for timely service plan updates when rolling over unused hours between quarters. Update quarterly reporting to include accurate utilization documentation.