MedicaidCoverageMedium impact
BT202603: FSSA implements extraordinary care allowance for Attendant Care and Participant Assistance and Care
Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
Dec 31, 2025
We identified it
Jun 18, 2026
Summary
Indiana FSSA has implemented a new extraordinary care allowance effective December 31, 2025, for individuals receiving Attendant Care and Participant Assistance and Care services through specific Medicaid HCBS waivers. This allowance covers intensive nursing care needs like tracheostomy care, ventilator management, TPN, and other complex medical conditions that require supervision by an interdisciplinary team.
Action Required
Immediately: Billing team should review current patients receiving Attendant Care (H&W Waiver, PathWays Waiver) or Participant Assistance and Care (Family Support Waiver) services to identify those who may qualify for extraordinary care allowance. Coordinate with waiver case managers to ensure proper documentation using Physician Certification for Long-Term Care Services (Form 450B) and obtain FSSA approval for qualifying cases. Update patient records to reflect extraordinary care status in Person-Centered Plans when approved.