IHCP bulletin

INDIANA HEALTH COVERAGE PROGRAMS BT2023106 AUGUST 31, 2023

IHCP announces new rates for CMHW, effective

Oct. 1, 2023
The Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) and
Division of Mental Health and Addiction (DMHA) publishes this notice of amendment and changes to the rates for the
Child Mental Health Wraparound (CMHW) State Plan benefit. The
Indiana Health Coverage Programs (IHCP) announces, effective
Oct. 1, 2023, the CMHW will have new rates, pending approval from
the Centers for Medicare & Medicaid Services (CMS).

Providers are asked to begin billing with the new rates listed in
Table 1 for claims with dates of service (DOS) on or after Oct. 1,
2023. After the CMS approves the rates, Gainwell Technologies will
mass adjust all claims for these CMHW services with DOS on or
after Oct. 1, 2023. For any CMHW claims that are submitted with
the old rates with DOS on or after Oct. 1, 2023, providers will be required to submit corrected claims to get paid the
new rate.

Table 1 –New rates for the CMHW program, effective for DOS on or after Oct. 1, 2023

Procedure
Modifier 1 Modifier 2 Service Service unit New rate
code
H2014 HA Habilitation Services 15 minutes $19.54

H2015 HA Training for Caregiver 15 minutes $19.54

S5151 HA Respite Routine-Daily Per day $402.97
S5151 HA U2 Respite PRTF-Daily Per day $408.77
T1005 HA Respite Routine-Hourly 15 minutes $14.53
T2022 HA Wraparound Facilitation Per month $1,074.69

Questions about the CMHW program should be directed to the FSSA DMHA Youth Services at
DMHAYouthservices@fssa.in.gov. Questions or concerns about billing and reimbursement can be directed to the
Indiana FSSA IHCP reimbursement mailbox: FSSA.IHCPReimbursement@fssa.in.gov. Please be sure to send
communications containing protected health information (PHI) to this mailbox via secure email.

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IHCP bulletin BT2023106 AUGUST 31, 2023

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