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New CMHW Rates Effective Oct. 2023

The Indiana Health Coverage Programs (IHCP) announces new rates for the Child Mental Health Wraparound (CMHW) program effective October 1, 2023. The new rates are pending approval from the Centers for Medicare and Medicaid Services and are listed in Table 1. Providers should begin billing with the new rates for claims with dates of service on or after October 1, 2023. Any claims submitted with the old rates for dates of service on or after October 1, 2023 will require corrected claims to be paid the new rates. Questions about billing changes should be directed to the IHCP reimbursement mailbox.

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34 views2 pages

New CMHW Rates Effective Oct. 2023

The Indiana Health Coverage Programs (IHCP) announces new rates for the Child Mental Health Wraparound (CMHW) program effective October 1, 2023. The new rates are pending approval from the Centers for Medicare and Medicaid Services and are listed in Table 1. Providers should begin billing with the new rates for claims with dates of service on or after October 1, 2023. Any claims submitted with the old rates for dates of service on or after October 1, 2023 will require corrected claims to be paid the new rates. Questions about billing changes should be directed to the IHCP reimbursement mailbox.

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Indiana Family to Family
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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@[Link]. Questions or concerns about billing and reimbursement can be directed to the
Indiana FSSA IHCP reimbursement mailbox: [Link]@[Link]. 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

QUESTIONS?

If you have questions about this publication, please contact Customer Assistance at 800-457-4584.

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please download them from the IHCP Bulletins by clicking the blue subscription envelope
page of the IHCP provider website at or sign up from the IHCP provider website
[Link]/medicaid/providers. at [Link]/medicaid/providers.

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