Indiana Medicaid pays for in-home personal care and related services through 3 programs, including the PathWays for Aging Waiver and the Health and Wellness Waiver (formerly Aged and Disabled Waiver). FSSA split the old Aged and Disabled Waiver on July 1, 2024: people 60 and older moved to PathWays managed care, and those 59 and under to the Health and Wellness Waiver run by the Bureau of Disabilities Services. An August 2026 Family Supports amendment limits paid relatives/guardians to Respite, PAC, Transportation, and Workplace Assistance, capped at 40 hours per week. Confirm EVV requirements and state plan personal care coverage with FSSA.
Which Indiana waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
PathWays for Aging Waiver
Population
Medicaid members age 60 and older who meet nursing facility level of care.
Services covered
attendant care
home and community assistance
skilled respite
structured family caregiving
adult day services
adult family care
caregiver coaching
home delivered meals
personal emergency response system
transportation
Billing format
1915(c) waiver delivered through Indiana PathWays for Aging managed care entities (Anthem, Humana, or UnitedHealthcare).
Children and adults with an intellectual or developmental disability or related condition (onset before 22) who have substantial limitations in at least three of six major life areas.
Services covered
participant assistance and care
respite
adult day services
day habilitation
remote supports
workplace assistance
transportation
personal emergency response system
case management
Billing format
Services are paid within an individual budget, with a maximum of $26,482 per person per year (2024 fact sheet).
To bill Medicaid for home care you need a state license, a Type 2 NPI, state Medicaid enrollment and screening, waiver or managed care contracts, EVV and authorizations.
Private pay means higher rates and fast payment; Medicaid means steady volume at state-set rates with authorizations and EVV. Compare rates, cash timing and admin before you mix them.
Track units remaining, the end date and the service code for every client, and check them before each schedule change. Hours over the cap are unbillable.
Four units equal one hour. How to convert units to hours, the common HCPCS codes, how states round partial units, and how to stay inside the authorization.
These free tools are made by the team behind Caregiver Scheduling,
caregiver scheduling software for home care agencies.
Simple pricing
From$199/month
Up to 10 caregivers on Starter, 50 on Growth.
More than 50 caregivers? We'll put together a custom Scale plan for your agency.
