MedicaidBilling CodesMedium impact
BT2024204: IHCP changes respite service names for PathWays, H&W and TBI waivers
Indiana Medicaid (IHCP)·IN·Managed Care
Effective date
Dec 17, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has renamed respite service billing codes for PathWays, Health & Wellness, and TBI waivers. Procedure code S5150 is now called 'Respite Care Services, HHA' instead of skilled respite, with specific modifier combinations required for different service levels.
Action Required
Immediately: Billing team must update service descriptions in billing system for Indiana Medicaid waiver services. Change S5150 to 'Respite Care Services, HHA' for PathWays, H&W and TBI waivers. Verify correct modifier combinations: S5150 uses U7+UA+U9, T1005 uses U7+UA+TE (LPN) or U7+UA+TD (RN). Update encounter forms and staff training materials to reflect new service names.