MedicaidAdministrativeMedium impact
BT2025163: IHCP reminds providers about HQ modifier usage for personal care services
Indiana Medicaid (IHCP)·IN·Provider Bulletin
We identified it
Jun 18, 2026
Summary
The Indiana Health Coverage Programs (IHCP) clarifies that the HQ modifier for personal care services may only be used when billing for services provided in a 24-hour congregate setting, not in non-24-hour congregate settings. This modifier indicates exemption from electronic visit verification (EVV) requirements for certain personal care services.
Action Required
Immediately: Billing team must review all personal care service claims to ensure HQ modifier is only applied when services are provided in 24-hour congregate settings. Remove HQ modifier from claims for non-24-hour congregate settings. Update billing system rules to prevent incorrect HQ modifier usage and train staff on proper modifier application based on service location.