How Indiana pays for disability services

Waiver inventory

Excluded: Health and Wellness Waiver (0210), PathWays for Aging (2407), and Traumatic Brain Injury Waiver (4197), although all three are slated to merge with FSW and CIH in the 2028 waiver reset.

State-only funded programs

Partially identified. Indiana operates "100% state-funded services" for some people with developmental disabilities. Both the FSW and CIH waiver applications and the DDARS provider reference module reference "eligible individuals transitioning from 100% state-funded services" as a reserved waiver capacity category and as a priority waiting list status. The August 1, 2026 amendments remove that reserved capacity category from both waivers.

• FSW: "Remove reserved waiver capacity for eligible individuals transitioning from 100% state funded services (App B-3-c)." in.gov
• CIH: identical language. in.gov
• Priority waitlist status language: in.gov

What these state-funded budgets pay for, their annual appropriation, and the number of people on them were not found in any FSSA, BDS, or State Budget Agency document retrieved. Checked: the DDARS main page, the BDS index page, the Medicaid HCBS Waivers page, the BDS Waiver Reset page, the waiver applications, and the DDARS HCBS Waivers provider reference module.

No other state-only DD program (no state-only respite grant, no state-only family support subsidy) was identified in the retrieved sources.

County / regional / local funding

None identified. Checked: the FSW and CIH waiver applications (Appendix B-3-e explicitly states "Waiver capacity is allocated/managed on a statewide basis," not to local or regional non-state entities), the DDARS HCBS Waivers provider reference module, the BDS index, and the HCBS waiver waiting list page. Indiana administers DD services through a single statewide Bureau of Disabilities Services with regional BDS offices; there is no county DD board, county levy, or regional center allocation analogous to Ohio's county boards or Illinois's 708 boards. Area Agencies on Aging serve as the intake point for the H&W and PathWays waivers, but they are contracted regional entities, not local funders of DD services.

Funding scale

• CIH waiver services, waiver year 1 of the current renewal: $967,352,251.57 across 9,438 participants. in.gov
• FSW waiver services, waiver year 1: $336,345,243.84 across 26,199 participants. in.gov
• Combined FSW plus CIH waiver services: roughly $1.30 billion per waiver year for about 35,600 people.
• Per participant, CIH: Factor D $102,495.47 (waiver services only); D + D' $113,561.52; ICF/IID comparison G + G' $196,865.66; average length of stay on the waiver 348 days. Same source.
• Per participant, FSW: Factor D $12,838.09; D + D' $28,607.39; ICF/IID comparison G + G' $118,469.19; average length of stay 343 days. FSW carries a hard annual waiver services cap of $26,482 per person; CIH has no fixed cap and uses an objective-based allocation. Same sources.
• State versus federal share: Indiana FMAP is 64.74% for FY2026, so the state share is 35.26%. kff.org
• Applying that FMAP to the combined waiver total implies roughly $460 million state share and $845 million federal share per waiver year. This is a calculation from the two published figures, not a figure Indiana publishes.
• Cost trend assumption: FSSA projected a 0.0% cost per unit trend across the renewal period, stating "the state does not expect the rates to change after rate review during the renewal period." FSW slot growth assumes about 165 new entrants per month against a 0.40% monthly lapse rate. in.gov
• Waiting list, FSW and CIH: numbers not published. FSSA's HCBS Waiver Waiting List page reports only Health and Wellness (6,836) and PathWays (11,779) as of August 2026, with 55,969 approved slots across those two for July 2025 to June 2026. in.gov
• What is known about the FSW and CIH queue: both waivers hit maximum capacity in December 2025, no new slots were to be released until at least July 2026, and people invited to begin the process are placed on hold until capacity opens. cdn.arcind.org and arcind.org
• Explicit state position on the waitlist: the waiver reset page states "There is no additional funding to complete the waiver reset, therefore, it unlikely that this reset will end the need for waitlists." in.gov

Residential funding detail

All residential support sits in the CIH waiver. The FSW has none, which is the structural reason CIH costs eight times more per person.

1. Residential Habilitation and Support, Hourly (T2016). Supported living in the person's own home or apartment. Two levels: Level 1 for 35 or fewer hours per week at $35.02 per hour, and Level 2 for over 35 hours per week at $30.36 per hour. The lower rate applies to the higher-volume tier. A participant-directed variant, Self-Directed Residential Habilitation and Supports (Hourly), exists. RHS Hourly is not reimbursed when provided by a legal guardian.
2. Residential Habilitation and Support, Daily (T2016), Indiana's group home per diem. Nine tiers priced on two axes: an acuity "Algo Level" (3, 4, or 5) crossed with household size (2, 3, or 4 people). Daily rates, effective as published August 1, 2025: - 2-person setting: Algo 3 $237.77, Algo 4 $331.74, Algo 5 $357.86 - 3-person setting: Algo 3 $233.90, Algo 4 $303.31, Algo 5 $332.84 - 4-person setting: Algo 3 $220.86, Algo 4 $280.27, Algo 5 $298.60

Limit one unit per day. Note the inverse relationship: per-person rates fall as household size rises, so a 4-person home at Algo 5 pays $298.60 against $357.86 for a 2-person home at the same acuity. 3. Structured Family Caregiving (T2033), Indiana's shared living / host home model, formerly Adult Foster Care. Three levels paid per day: Level 1 $77.54, Level 2 $99.71, Level 3 $133.44. Only agencies may be SFC providers; the home is assessed for accessibility. SFC is not reimbursed when provided by the parent of a minor participant or a spouse, but is reimbursed when provided by another relative or a legal guardian if conditions are met. SFC and RHS are mutually exclusive. 4. Rent and Food for Unrelated Live-In Caregiver (T2025), $545.00 per month, CIH only. Paid caregivers are not eligible. 5. Community Transition (T2038), individually priced, $2,500 lifetime cap, to set up a household when leaving an institution. 6. Supervised Group Living (SGL), Indiana's ICF/IID group homes, funded outside the waiver through the ICF/IID state plan benefit and administered by BDS.

Payment structure summary: hourly for supported living, acuity-by-household-size per diem for group homes, flat per diem by level for shared living, and a flat monthly amount for live-in caregiver rent and food.

Room and board: entirely the participant's responsibility. The waiver states, "The State of Indiana excludes Medicaid payment for room and board for individuals receiving services under the waiver. Waiver participants are responsible for all room and board costs. There is no consideration of the cost of room and board in developing the rates." In practice this falls to SSI. The one exception is the Rent and Food for Unrelated Live-In Caregiver service, which reimburses the incremental rent and food attributable to the caregiver, not the participant. in.gov

Rate structure link: Table 3, Medicaid Waiver Services, Codes and Rates for FS and CIH Waivers, Section 9.2 of the DDARS HCBS Waivers provider reference module: in.gov

Comparable service rates

From Table 3 of the DDARS HCBS Waivers provider reference module, Library Reference Number PRPR10014, Version 12.1, published May 28, 2026, reflecting policies as of August 1, 2025. Cross-checked against Appendix J of the August 1, 2026 waiver amendments.

Other notable rates from the same table: Adult Day Services half day Level 1 / 2 / 3 at $37.18 / $43.75 / $54.74; Behavior Management $18.56 per 15 minutes (both waivers); Intensive Behavioral Intervention Level 1 $104.60 and Level 2 $39.53 per hour; Music Therapy and Recreational Therapy $16.81 per 15 minutes; Remote Supports $24.26 (1 person), $12.13 (2), $8.09 (3), $6.06 (4) per hour; Transportation $15.05 / $26.52 / $47.88 per trip by level with annual caps of $7,530 / $8,255 / $8,980; Home Modification Install capped at $20,000 lifetime; Specialized Medical Equipment install capped at $15,000 lifetime; Vehicle Modification $15,000 per vehicle every 10 years; Family and Caregiver Training $5,000 per year.

Rates confirmed effective January 1, 2026 by bulletin BT2025169: Behavior Support Services in three components (Consultation capped at 3 hours monthly, Comprehensive at 12 hours monthly or 144 annually, functional behavioral assessment at 20 hours over 60 days), all at $18.56 per 15 minutes; Extended Services Employment Support $52.85 per hour; Benefits Counseling $50.00 per hour. secure.in.gov

Official rate schedule links

• DDARS HCBS Waivers provider reference module, Section 9.2 Table 3 (the actual FSW and CIH rate table): in.gov
• Alternate hosting of the same module: in.gov
• IHCP Fee Schedules search tool: in.gov
• IHCP Bulletin BT2025169, January 1, 2026 waiver service and rate changes: secure.in.gov
• IHCP Bulletin BT2025170, waiver invitation timelines effective November 26, 2025: secure.in.gov
• CIH waiver application effective August 1, 2026, with Appendix I rate methodology and Appendix J rate tables: in.gov
• FSW waiver application effective August 1, 2026: in.gov
• Prior versions, effective December 31, 2025: in.gov and in.gov
• August 2026 amendment fact sheets: in.gov and in.gov
• FSSA 2026 waiver approval announcement: in.gov
• DDRS HCBS Rate Review, May 2023: in.gov
• July 2023 public notice on rates and RHS alignment: in.gov

Notable features and flags

• August 1, 2026: CMS approved amendments to all five HCBS waivers plus two 1915(b)(4) waivers, and FSSA rescinded the live-in caregiver rate increases it had proposed. The announcement states FSSA removed proposed rate increases for Attendant Care, Participant Assistance and Care, and Residential Habilitation and Support involving live-in caregivers, and "will revisit a rate adjustment for certain personal care services involving a live-in caregiver in future waiver amendment cycles." in.gov
• December 2025: both the FSW and CIH waivers hit maximum capacity. No new slots were to be released until at least July 2026, and people who complete eligibility are placed on hold until capacity opens. Bulletin BT202623 confirms the July 2024 renewal reduced overall enrollment slots. arcind.org and secure.in.gov
• December 31, 2025: the 2023-2025 redesign's biggest service cuts took effect. Facility-based Prevocational services stopped accepting new enrollments and were eliminated for cost-projection purposes, with those participants shifted to Day Habilitation. Behavior Management Basic was replaced by a three-component Behavior Support Services model capped at 12 hours per month. Music Therapy and Recreational Therapy were each capped at 6 hours per month. Consumer-directed attendant care and participant-directed home care were sunset on H&W and PathWays. secure.in.gov and in.gov
• Self-direction launched January 1, 2026 with a built-in 10% budget haircut. FSSA assumed 2% of members would self-direct and that doing so would "reduce their budget by 10%," with average cost per unit adjusted down 0.2% for Respite, PAC, and Workplace Assistance. On FSW, legally responsible individuals may be paid for PAC if extraordinary care criteria are met, limited to 40 hours per week. On CIH, legally responsible individuals and legal guardians cannot be paid caregivers under self-direction. in.gov and cdn.arcind.org
• August 1, 2026: case management moved to five selected contractors statewide under a 1915(b)(4) selective contracting waiver, replacing the prior case management arrangement. in.gov and in.gov
• Waiver reset timeline: a Youth Waiver launches July 1, 2027 for ages 0 to 21 (initially FSW recipients), and full consolidation of CIH, FSW, H&W, and TBI into a single reset structure is planned for 2028. FSSA states flatly that there is no additional funding for the reset and it is unlikely to end waitlists. in.gov
• Enrollment timelines tightened twice in 2025. Effective November 26, 2025, invitees have 30 days to accept and then 180 days to complete enrollment, down from a 60-day window for those invited January 15 to July 15, 2025. Missed deadlines trigger rescission and reassignment of the slot. secure.in.gov
• January 2026: a 365-day supervised-setting residency requirement was imposed on people transitioning from group homes to the CIH waiver. arcind.org

Confidence

Solid: the complete FSW and CIH rate table with HCPCS codes, modifiers, units, and unit limits, taken directly from the state's own provider reference module and cross-validated against Appendix J of the CMS-approved August 1, 2026 waiver applications; CMS-approved participant limits; the FSW $26,482 annual cap; per-participant Factor D and cost-neutrality figures; the room and board exclusion; the residential service architecture including the nine RHS Daily tiers and three SFC levels; the 2025-2026 service cuts and their effective dates; and FMAP.

Estimated: the split of the combined $1.30 billion waiver total between state and federal share. That is my arithmetic applying the FY2026 FMAP to two published totals, not a figure Indiana publishes. Also note the provider module is dated "policies and procedures as of Aug. 1, 2025" even though it was published May 28, 2026, so a small number of rates may have moved with the January 1, 2026 or August 1, 2026 amendments; where a bulletin confirmed a 2026 rate, I have cited it separately.

Could not find: FSW and CIH waiting list counts, which FSSA does not publish (its public waitlist page covers only Health and Wellness and PathWays). Also not found: the nature, appropriation, and enrollment of Indiana's "100% state-funded services" for people with developmental disabilities, despite that category appearing in both waiver applications and the provider module; ICF/IID and Supervised Group Living per diem rates; the Indiana State Budget Agency's FSSA line-item detail for DD; and any county or local DD funding stream, which I believe does not exist but could confirm only by absence across six state sources.