MedicaidBilling CodesMedium impact
BT2024136: Differences clarified between HCBS Transportation service under PathWays Waiver and NEMT service
Indiana Medicaid (IHCP)·IN·Managed Care
Effective date
Aug 27, 2024
We identified it
Jun 19, 2026
Summary
Indiana clarifies differences between HCBS Transportation under PathWays Waiver (for nonmedical community activities) and NEMT service (for medical appointments only). Both use different billing codes, eligibility requirements, and documentation standards.
Action Required
Immediately: Billing team must verify correct transportation service type before billing T2003. For PathWays Waiver HCBS transportation, use T2003 with modifiers U7+U1+UB (nonassisted base), U7+U1 (nonassisted mileage), U7+U2+UB (assisted base), or U7+U2 (assisted mileage). Ensure service authorization exists and participant is not in Adult Family Care/Assisted Living. For NEMT, follow existing broker billing procedures. Update billing system to distinguish between waiver and non-waiver transportation claims.