Indiana Health Coverage Programs cover specified CHW services when workforce, employment, supervision and documentation conditions are met. Recognized training and certification do not make every navigation activity payable. This guide explains the qualification routes, covered-service boundaries and operating workflows Indiana program leads should review before choosing CHW software. [1, 2]
Indiana CHW quick facts
| Topic | Indiana guidance |
|---|---|
| Workforce resources | Indiana Department of Health and Indiana Community Health Workers Association. [3, 4] |
| IHCP qualification | BT2024198 recognizes ASPIN, DMHA and INCHWA, plus specified competency-based alternatives. [1] |
| Worker enrollment | CHWs do not individually enroll as IHCP providers under this pathway. [1] |
| Employment | CHW works for an IHCP-enrolled billing provider. [1] |
| Supervision | A qualifying IHCP-enrolled practitioner supervises the service. [2] |
| Claim identity | Supervisor NPI as rendering provider; CHW name in claim notes. [2] |
| Service codes | 98960, 98961 and 98962, with different group sizes. [2] |
| Service boundary | Covered education and prevention differ from excluded navigation, case management and transportation tasks. [1, 2] |
| Training examples | IDOH links ASPIN, HealthVisions, Ivy Tech and University of Indianapolis resources. [3] |
| Last reviewed | November 6, 2026 |
For program leaders
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What do Indiana CHWs do?
IDOH describes CHWs as trusted community members who connect people with health and social services and support education, advocacy and access. Its workforce page identifies training and professional resources. [3]
The occupational role is broader than any one payment benefit. A worker may help with education, engagement and resource navigation while only some activities meet the conditions of a particular payer.
Define the position’s population, duties and clinical escalation route. Explain to staff which records support participant continuity and which additional evidence is needed for reimbursement review.
How do you become qualified as a CHW in Indiana?
The September 2026 IHCP Provider Enrollment module recognizes certification through ASPIN, DMHA and INCHWA, as well as other training organizations addressing the identified CHW competencies. Healthcare education or internal orientation should not be treated as automatic qualification for an unlisted route. Current Provider Enrollment module, pages 33 to 34. The December 2024 bulletin provides earlier policy context. [1]
Retain the curriculum and a documented qualification review.
Choose a training route that fits the intended role. A general CHW program and a peer-support credential can involve different eligibility and service conditions. Record the actual award rather than treating every CHW as a peer specialist.
Where can you find Indiana CHW training?
IDOH’s resource list includes ASPIN, HealthVisions, Ivy Tech and University of Indianapolis options. INCHWA maintains a separate list of recognized training vendors and explains its curriculum-review process. [3, 4]
Ask the provider about current recognition, course schedule, total cost, field or capstone work and completion evidence. Confirm which credential the student receives and how it relates to the employer’s intended service.
For a team, compare full pathways instead of a single advertised class. Identify paid training time, supervision and who will verify completion. A provider’s former cohort page should not be used to promise an available place or scholarship.
How should an employer compare training options?
| Item to verify | Why it matters |
|---|---|
| Actual credential and issuer | Course participation is different from an issued completion award |
| Curriculum | IHCP recognizes competency-based training, not simply a job title |
| Practice and assessment | A worker needs to demonstrate the duties the employer assigns |
| Total cost and time | Tuition, work-release time and any membership component should be clear |
| Service-specific orientation | General preparation does not replace the billing provider’s oversight |
IDOH lists Ivy Tech’s one-credit, eight-week examples and an eight-week hybrid University of Indianapolis course among its resources. These are provider examples, not a universal Indiana hour requirement. INCHWA separately describes its recognized-program review and electronic award for successful graduates. Confirm the exact course and current recognition before purchasing training. IDOH training resources and INCHWA education.
INCHWA’s vendor page also describes a $40 membership component included within recognized-program tuition, with two-year network membership. That is an association-program term, not a statewide certification renewal fee. Ask the training vendor what its complete price includes. INCHWA recognized-vendor information.
What does INCHWA recognition mean?
INCHWA describes recognized training as evaluated against CHW competency standards, with participatory learning, experienced instructors and a capstone. It identifies an INCHWA-issued electronic certificate for successful graduates of recognized programs. [4]
Keep the distinction between vendor recognition and an individual’s award. A vendor appearing in a directory is not proof that a particular employee completed its program.
For onboarding, retain the certificate, training dates, issuer and any role-specific education. Verify current status using the applicable issuer’s instructions instead of assigning a universal renewal requirement from another credential.
Are there specialized perinatal training resources?
IDOH and My Healthy Baby publish CHW learning modules developed with WeCare at the Regenstrief Institute. The modules are intended for perinatal CHWs, with a certificate for each completed module achieving at least 80%. [5]
Use specialty learning to support the program’s duties, alongside foundational preparation. A module certificate is not automatically the whole workforce qualification for an IHCP service.
For a maternal-health team, define who follows up on an unmet need, where clinical questions are escalated and what information a partner needs for a handoff. Evaluate those routines during supervised practice.
Who can supervise Indiana Medicaid CHW services?
The Medical Practitioner Reimbursement module lists physicians, health service providers in psychology, APRNs, physician assistants, podiatrists and chiropractors as qualifying IHCP-enrolled supervisors. The billing provider retains CHW certification evidence. [2]
Record the actual supervisor and enrollment information applicable to the service. A staff manager’s operational approval is not necessarily the same as payer-required practitioner supervision.
Keep a backup process for absences and role changes. Before a new assignment begins, confirm who is responsible for clinical questions, documentation review and the service’s supervision conditions.
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Which CHW services does IHCP cover?
The cited guidance covers diagnosis-related education, cultural brokering with the healthcare team, health-promotion education and direct preventive services or services slowing chronic-disease progression. It excludes insurance-navigation assistance, case management, care coordination and arranging or providing transportation from this CHW benefit. [1, 2]
That boundary should shape the documentation. A useful transportation referral remains valuable participant support, but its value does not turn it into a payable education service.
For a mixed contact, document the actual activities and apply the governing billing rules to the qualifying work. Do not relabel excluded tasks to fit a code.
What are the Indiana CHW billing codes and limits?
The module identifies 98960 for an individual, 98961 for groups of 2 to 4 and 98962 for groups of 5 to 8, in 30-minute units. It specifies face-to-face delivery and limits of four units daily and 24 monthly per member. [2]
The bulletin states that prior authorization is not required, while medical-necessity evidence and unit limits still apply. [1] No prior authorization requirement is not a waiver of coverage conditions.
Use the current professional fee schedule for the date of service and the member’s managed-care instructions when applicable. Do not treat the code list as a universal dollar rate or a guarantee of payment.
How should the claim identify the worker?
The supervising practitioner’s NPI is listed as the rendering provider, and the CHW’s name appears in claim notes. Separate service dates require separate claim lines, with an appropriate diagnosis. [2]
Preserve both the person who performed the work and the supervising practitioner in the service record. An exported claim identity should not overwrite the actual author.
Have the billing lead validate the mapping from service record to claim output. This guide explains the workflow; it does not imply that Smores Health currently submits Medicaid claims.
How should a mixed education and navigation contact be reviewed?
Consider a fictional participant who receives self-management education and then asks for help arranging a ride. The note can explain both activities, but the billing review should preserve their different purposes. The IHCP CHW benefit includes specified education and preventive work while excluding transportation arrangement and case management from that benefit. Record the service actually delivered rather than using a covered code to rename every task. Medical Practitioner Reimbursement module, pages 7 to 8.
A practical review checklist separates worker qualification, enrolled employer, qualifying practitioner supervision, covered content, face-to-face delivery, medical necessity and applicable time limits. Claim preparation then uses the supervising practitioner as rendering provider and includes the CHW’s name in claim notes. The author of the service record should remain visible through that mapping. IHCP CHW billing guidance, page 8.
The module addresses fee-for-service reimbursement and directs providers to the member’s managed-care entity for managed-care payment information. Keep the actual member arrangement and service date with the billing review. A general platform demonstration or completed note is not the payer’s determination. Module introduction, page 1.
What should an Indiana CHW encounter note show?
Recommended core elements include date, worker, program, participant goal, contact method, activity, response and next action. Add medical-necessity, time, group and supervision evidence needed for the applicable service.
For an education encounter, explain what the participant learned and how they responded. For a referral task, record the destination, barrier and follow-up. Keeping the activities distinguishable makes the record more useful for both care and funding review.
Avoid automatically marking every completed note billable. Credential, supervisor, service content, delivery method and limits need their own checks.
How should referrals and nonbillable work be reported?
Use an activity record that recognizes work beyond the covered CHW benefit. Grant-funded outreach, navigation and transport coordination may belong in a different report or agreement.
Track referrals through offered, accepted, sent, acknowledged and assistance received. Preserve declined and unavailable outcomes. A completed staff task should not close an unmet need without supporting evidence.
For a director, report unique participants, contacts, education services, referral outcomes and unresolved needs separately. This avoids inflating a claim-oriented total with broader program activity.
What should Indiana CHW software support?
Test a connected workflow for qualification evidence, supervisor assignment, encounter documentation, referrals and reporting. Permissions should distinguish workforce files, participant records and billing review.
Explore community health workflows and the Smores Health platform. Bring a training checklist, an education-note example and one required report. Ask how current functionality would support the workflow and which parts need configuration.
Review how corrections are preserved and how a report can be reproduced. A code suggestion or credential checkbox should not automatically certify medical necessity or payment.
What should you test in an Indiana CHW demo?
Use a fictional participant receiving health education and separate help arranging transportation.
- Assign the qualified worker and appropriate supervisor.
- Record the education content and participant response.
- Document the transportation task as a distinct activity.
- Review service time and return an unclear note for correction.
- Export reports that keep covered-service review separate from all program activity.
Ask for a complete price covering setup, migration, training, reporting and support. Verify export formats and implementation responsibility. Book a program walkthrough with Smores Health to evaluate this scenario with your team.
See it in your program
Build your program around a connected workflow.
Bring your forms and reporting needs. See how Smores Health connects service notes, supervisor review, and program reporting in a walkthrough focused on your team.
A 20-minute walkthrough for your program.
Frequently asked questions
Do CHWs individually enroll with IHCP?
The cited CHW pathway uses employment by an enrolled billing provider rather than individual CHW enrollment. [1]
Are ASPIN, DMHA and INCHWA the only possible qualification sources?
The bulletin also describes competency-based alternatives. Review the actual curriculum and qualification evidence rather than assume automatic acceptance. [1]
Can transportation coordination be billed as CHW education?
The cited benefit excludes arranging or providing transportation. Document that work honestly under the appropriate program. [1]
Does a no-PA rule guarantee payment?
No. Coverage, medical necessity, qualifications and limits still apply. [1]
Should the supervising NPI replace the CHW’s identity in the note?
No. Preserve the actual worker’s authorship and supervisor information. Claim mapping has its own identity requirements. [2]
Build a clearer Indiana CHW workflow
Bring one covered-service example, one community referral and a reporting obligation to Smores Health. Review documentation, supervision and follow-up in a focused session. Book a program walkthrough or request pricing for your organization.
Sources
[1] IHCP, BulletinBT2024198. https://www.in.gov/medicaid/providers/files/bulletins/BT2024198.pdf
[2] IHCP, Medical Practitioner Reimbursement module, February 2026. https://www.in.gov/medicaid/providers/files/modules/medical-practitioner-reimbursement.pdf
[3] Indiana DOH, CHW resources. https://www.in.gov/health/cdpc/community-health-workers
[4] INCHWA, recognized training and workforce resources. https://www.inchwa.org/resources
[5] My Healthy Baby, perinatal CHW modules. https://www.in.gov/myhealthybaby/for-family-support-partners/