DDRS Update: Direct Support Professionals Rate Increase - Billing

This update announcement is regarding mass reprocessing of provider claims associated with the 14% rate increases implemented with an effective date of July 1, 2021.  ​

Prior communications advised that mass claims adjustments related to the legislated 14% rate increase toward   wages and benefits paid to eligible direct support professionals would be automatically processed without requiring providers to resubmit claims for the following services:

• Adult day services – Level 1, 2 and 3
• Prevocational services
• Respite
• Extended services
• Day habilitation – Individual and group small, medium and large
• Workplace assistance
• Transportation services – Level 1, 2 and 3
• Participant assistance and care
• Facility based support
• Residential habilitation and support (daily & hourly)

​On Sept. 14, 2021,  BR202137 announced the Indiana Health Coverage Programs was correcting that statement noting claims would not be mass adjusted and providers should resubmit the claims. While the Bureau of Developmental Disabilities Services worked with the Office of Medicaid Policy and Planning on ways to allow for mass reprocessing of those claims, there were a number of issues identified that ultimately prevent claims from being handled in this manner.

As a result of the issues identified, mass adjustments cannot be completed for providers. Providers who submitted a plan will need to resubmit their eligible claims to remit the 14% rate increases that were effective July 1. 
*Guidelines for re-submission of claims can be located at:

• https://www.in.gov/medicaid/providers/files/claim-submission-and-processing.pdf
• https://www.in.gov/medicaid/providers/files/electronic-data-interchange.pdf

  
The DDRS is a program of the Indiana Family & Social Services Administration. If you have questions about DDRS programs and services, visit us online at www.DDRS.In.gov.