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Indiana Medicaid (IHCP)Medicaid · Reimbursement · Provider Bulletin · IN · Geriatrics, Physical Therapy, Occupational Therapy +2 moreMedium impact

BT202359: IHCP announces new rates for DA and DDRS waivers, effective July 1, 2023

Effective date
Jul 1, 2023
Identified
Jun 19, 2026

Summary

Effective July 1, 2023, pending approval from the Centers for Medicare & Medicaid Services, Indiana Medicaid sets new rates for Division of Aging Aged and Disabled (A&D) and Traumatic Brain Injury (TBI) waiver services, and for Division of Disability and Rehabilitation Services Community Integration and Habilitation (CIH) and Family Supports Waiver (FSW) services. Rate changes are listed by procedure code, modifier, service unit and limit, for example Care Management rises from $134.33 to $189.56 monthly for A&D/TBI and from $143.75 to $189.56 monthly for CIH/FSW, and Home Delivered Meals rise from $6.00 to $7.76 per meal. Some rates, such as Physical Therapy (G0151) and Psychological Therapy (90846 and 90853), stay the same.

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What to do

Action · 6 steps
01Already effective July 1, 2023, pending CMS approval: Billing team: begin billing with the new rates for waiver claims with dates of service on or after July 1, 2023, using the rate tables in the bulletin.
02After CMS approves the rates, Gainwell Technologies will mass adjust all claims for these home- and community-based services waivers with dates of service on or after July 1, 2023.
03For any waiver claims submitted with the old rates with dates of service on or after July 1, 2023, providers will be required to submit corrected claims to get paid the new rate.
04Procedure code T2039 is used in both A&D and TBI waivers.
05Corrections to this bulletin are posted in IHCP Bulletin BT202378.
06Send questions to FSSA HCBS Rate Methodology by email.

Codes mentioned

97535B4150H0004H2023S5100S5125S5130S5140S5141S5150S5160S5161S5165S5170T1005T1028T2003T2021T2022T2025T2029T2031T2038T2039908469085392507A9279G0151G0152H2020H2032S5101S5111S5116S5151T1020T2002T2015T2016T2020T2033

Original notice

BT202359: IHCP announces new rates for DA and DDRS waivers, effective July 1, 2023
in.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Indiana Medicaid (IHCP) changes →
BT202020: FSSA will change rates and services for the FSW and CIH Waiver, pending CMS approvalMediumEffective Apr 17, 2020 · Specialty ServicesBT202083: FSSA changes rates and services for the FSW and CIH WaiverMediumEffective Jul 16, 2020 · Specialty ServicesBT202006: FSSA changes rate and methodology for A&D and TBI waiver servicesMediumEffective Feb 1, 2020 · Claims & BillingBT2025169: IHCP and DDARS announce changes to waiver services, effective Jan. 1, 2026HighEffective Jan 1, 2026 · Specialty ServicesBrowse every Indiana Medicaid (IHCP) change in the policy list

Related policy hubs

Indiana Medicaid (IHCP) policiesIN policy changesGeriatricsPhysical TherapyOccupational TherapySpeech TherapyPsychiatryCode 97535Code B4150Code H0004Code H2023Code S5100Code S5125Code S5130Code S5140Code S5141Code S5150Code S5160Code S5161Code S5165Code S5170Code T1005Code T1028Code T2003Code T2021Code T2022Code T2025Code T2029Code T2031Code T2038Code T2039Code 90846Code 90853Code 92507Code A9279Code G0151Code G0152Code H2020Code H2032Code S5101Code S5111Code S5116Code S5151Code T1020Code T2002Code T2015Code T2016Code T2020Code T2033

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