Indiana Medicaid is starting to more strictly enforce limits that have already existed for some services in the Child Mental Health Wraparound (CMHW) program. These limits apply to the amount of certain services that can be provided each day or month.
What services are affected?
Skills Training and Development
- Limited to 3 hours per day
- Limited to 30 hours per month
Comprehensive Community Support
- Limited to 2 hours per day
- No yearly limit was announced.
Respite Care
- Limited to 6 hours and 45 minutes per day
What does this mean for families?
These service limits are not new. Indiana Medicaid is now enforcing limits that were already part of the CMHW program rules. Claims for services provided above these limits may not be paid.
Indiana Medicaid will also review claims paid between August 1, 2025, and August 1, 2026, and make adjustments if services exceeded the established limits. Providers will receive information about any claim adjustments beginning in September 2026.
What should families do?
Families who use CMHW services may want to:
- Talk with their care coordinator or provider about how these limits could affect their child's services.
- Review their child's service plan if they are concerned about meeting their needs within the allowed service amounts.
- Contact their provider if they have questions about how services are billed.
Bottom line: The state is not creating new service limits, but it is beginning to enforce existing limits more consistently for certain Child Mental Health Wraparound services.
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