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Indiana Medicaid (IHCP)Medicaid · Reimbursement · Specialty Services · IN · Psychiatry, Occupational Therapy, Physical Therapy +2 moreMedium impact

BT202020: FSSA will change rates and services for the FSW and CIH Waiver, pending CMS approval

Effective date
Apr 17, 2020
Identified
Jun 19, 2026

Summary

Indiana rates and services for the Family Supports Waiver (FSW) and the Community Integration and Habilitation (CIH) Waiver are scheduled to change for dates of service on or after April 17, 2020, pending CMS approval. Case management is priced at $143.75 per month for DD (U5) under T2022 with U7, up from $131.25. The FSW adds environmental modification, equipment assess/inspect/train (T1028), remote supports (A9279) and transportation Levels 2 and 3 (T2002). For CIH, Remote Supports replaces the service previously called Electronic Monitoring, and Community Transition (T2038) receives a $2,500 lifetime cap. Family and caregiver training (S5111 and S5116) caps increase to $5,000 per year for both waivers. Day habilitation codes (T2020) are renamed by group size. Case Management Annual PCISP Work (T2024) ends 3/31/2020, and several facility and community habilitation group codes under T2020 end 4/30/2020. The bulletin states an announcement will be made after CMS approval is received.

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What to do

Action · 6 steps
01Already effective April 17, 2020, pending CMS approval as stated in the bulletin: Billing team must note the effective dates and bill the new procedure code and modifier combinations and new rates for services that are changing for dates of service on or after April 17, 2020.
02Billing team must stop billing T2024 Case Management Annual PCISP Work after 3/31/2020, and must stop billing the facility and community habilitation group codes under T2020 listed as end-dated after 4/30/2020.
03For CIH, Remote Supports is billed under the code formerly called Electronic Monitoring.
04Billing team must check that Family and Caregiver Training (S5111 and S5116) for individuals is capped at $5,000 per year, and that Community Transition (T2038) is capped at $2,500 lifetime for CIH.
05Watch for the announcement that FSSA will make after CMS approval is received.
06Questions go to the FSSA IHCP reimbursement mailbox at FSSA.IHCPReimbursement@fssa.in.gov, and secure email must be used for communications containing personal health information.

Codes mentioned

T2022T1028S5165A9279T2002T2038S5111S5116T2020T2024S5101S5100H0004T2025H2020H2032G0152T2033S5160S5161G0151T20159084690853T2016S5151T1005T202992507T1020T2039

Original notice

BT202020: FSSA will change rates and services for the FSW and CIH Waiver, pending CMS approval
in.gov · Always check the source before changing claims.
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Related changes

See all Indiana Medicaid (IHCP) changes →
BT202083: FSSA changes rates and services for the FSW and CIH WaiverMediumEffective Jul 16, 2020 · Specialty ServicesBT202359: IHCP announces new rates for DA and DDRS waivers, effective July 1, 2023MediumEffective Jul 1, 2023 · Provider BulletinBT202006: 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 changesPsychiatryOccupational TherapyPhysical TherapySpeech TherapyPediatricsCode T2022Code T1028Code S5165Code A9279Code T2002Code T2038Code S5111Code S5116Code T2020Code T2024Code S5101Code S5100Code H0004Code T2025Code H2020Code H2032Code G0152Code T2033Code S5160Code S5161Code G0151Code T2015Code 90846Code 90853Code T2016Code S5151Code T1005Code T2029Code 92507Code T1020Code T2039

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