MedicaidDocumentationMedium impact
BT202449: LRI documentation and billing guidance clarified for certain A&D waiver services
Indiana Medicaid (IHCP)·IN · Geriatrics, Family Medicine·Claims & Billing
Effective date
Mar 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) has clarified documentation requirements for A&D waiver services billing. When billing for Structured Family Caregiving or Attendant Care services, providers must include a claim note with the caregiver's name and relationship to the member in a specific format, prioritizing Legally Responsible Individuals (parent of minor child or spouse).
Action Required
Immediately: Billing team must ensure all A&D waiver Structured Family Caregiving and Attendant Care claims include caregiver information in claim notes using the required format (NAME: REL: or NAME- REL- etc.). For electronic claims, submit notes at detail level in the NTE segment for 837P transactions. For multiple caregivers on same day, prioritize LRI information. Claims without proper caregiver documentation will be denied.