MedicaidBilling CodesMedium impact
BT202479: IHCP adds Home Modification Assessment service to TBI, CIH and FSW
Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Occupational Therapy·Provider Bulletin
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Summary
IHCP is adding Home Modification Assessment service to three waivers (TBI, CIH, FSW) effective July 1, 2024. New procedure code T1028 with specific modifiers will be used for assessment and inspection services, with separate billing for specifications ($409.46) and exam ($218.54).
Action Required
Before July 1, 2024: Billing team must add new procedure code T1028 with modifiers U7 (for TBI) and U7+U5 (for CIH/FSW) to billing system for Home Modification Assessment services. Set up separate billing capability for specifications ($409.46) and exam ($218.54) components. Update system to enforce requirement that final inspection must be completed before any home modification reimbursement.