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OMPP HCBS: Indiana PathWays for Aging Waiver (IHCP Provider Reference Module, PRPR10021) - Services and Reimbursement Rates

Indianasub_regulatoryIndiana Health Coverage Programs (IHCP) / OMPP· effective 2025-08-01

What this rule requires your agency to do

  • 1Home Modifications are subject to a $20,000 lifetime cap for installation and a $1,000 per year maintenance limit.(OMPP HCBS: Indiana PathWays for Aging Waiver (IHCP Provider Reference Module, PRPR10021) - Services and Reimbursement Rates)
  • 2Structured Family Caregiving is reimbursed as a per-day rate by level: Level 1 $77.54, Level 2 $99.71, Level 3 $133.44.(OMPP HCBS: Indiana PathWays for Aging Waiver (IHCP Provider Reference Module, PRPR10021) - Services and Reimbursement Rates)
  • 3Home and Community Assistance must be billed under S5130 (Agency U7 UA $7.93; Non-Agency U7 $7.68) per 0.25 hour.(OMPP HCBS: Indiana PathWays for Aging Waiver (IHCP Provider Reference Module, PRPR10021) - Services and Reimbursement Rates)
  • 4Attendant Care must be billed under S5125 with the applicable modifiers at the scheduled rate ($8.59 per 0.25 hour Agency U7 UA; $8.21 per 0.25 hour Non-Agency U7).(OMPP HCBS: Indiana PathWays for Aging Waiver (IHCP Provider Reference Module, PRPR10021) - Services and Reimbursement Rates)

Applies to: personal care

PathWays for Aging provider reference module and reimbursement rate schedule, listing the covered personal-care waiver services and their procedure codes, modifiers, and rates (e.g., Attendant Care, Home and Community Assistance, Structured Family Caregiving levels).

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.