Home and Community-Based Services (HCBS) Waiver Service Code Updates Implementation Guide
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Governance of HCBS waiver service name, code, and modifier changes effective January 1, 2026, and related implementation steps affecting Iowa Medicaid FFS and CCO providers, case managers, and MCOs.
Multiple HCBS service names and procedure codes/modifiers are changed or consolidated effective 01/01/2026 (e.g., personal care/CDAC to Attendant Care T1019; S5125 variations to S5125 and S5125 U3; S5130 Home Maintenance Support replacing S5120; retirement of T2018; addition of H2021 UC, H0004 UC).
IoWANS system will automatically update FFS service plans and provider service enrollments on 01/02/2026; manual entry required for plans not automatically updated.
EVV compliance requirement for MCO enrollees transitioning from Chore S5120 to Home Maintenance Support S5130: providers must enter Home Maintenance services into EVV by 04/01/2026.
Notices of Decision (NODs) are required only when a service code/modifier change needs authorization; name-only changes do not require NOD issuance unless requested.
Coverage Criteria and Service Mapping
Service mapping and required actions
Mapping and authorization implications for services listed in the guide:
Service-specific actions (ONE or more apply)
- Home Maintenance Support (S5130): replaces Homemaker/Chore services (including S5120); update service name, service plans, and authorizations to S5130 Home Maintenance Support (15-min unit). For MCO-enrolled members transitioning from Chore to Home Maintenance Support, providers must be EVV-compliant and enter Home Maintenance Support services into EVV by 04/01/2026.
Updated Procedure Codes and Authorization Dates
| T1019 | Attendant Care Self-directed (15 min unit); replaces Personal Care Services - CDAC individual non-skilled. |
| T1019 U3 | Attendant Care Skilled Self-directed (15 min unit); replaces Personal Care Services - CDAC individual skilled (skilled self-directed). |
| S5125 | Attendant Care (15 min unit); agency non-skilled Attendant Care (renamed to Attendant Care). |
| S5125 U3 | Skilled Attendant Care (15 min unit); S5125 with U3 modifier for skilled agency attendant care. |
| S5130 | Home Maintenance Support (15 min unit); renaming from Homemaker/Chore services and replaces S5120. |
| S5135 | Companion Care (15 min unit); renaming from Companion Care Adult - Senior Companion. |
| T2018 | T2018 UC Supported Employment (per hour); ending Self-Directed Community Support and Employment as duplicative. |
| H2021 UC | H2021 UC Family Training Services (15 min unit); adds UC modifier for BI Waiver and MFP. |
| H0004 UC | H0004 UC Positive Behavioral Support and Consultation (15 min unit); replaces H0031/H0032 Behavioral Programming for BI and MFP. |
Required Provider and Case Manager Steps
Update service plans, CCO budgets, and authorizations for code/modifier changes
Case managers must update service plans and CCO budgets (as applicable) for any service that has both a name change and a procedure code or modifier change, reflect the new service name and updated procedure code/modifier, and use a begin date of 01/01/2026; all updates must be completed by January 31, 2026. IoWANS will automatically update many FFS service plans on January 2, 2026, but plans not auto-updated require manual entry by the case manager.
- Update the service plan and the CCO budget, as applicable.
- Reflect the new service name and updated procedure code/modifier.
- Use a begin date of 01/01/2026 for these updates.
- Complete all updates no later than January 31, 2026.
- If an FFS plan did not automatically update on January 2, 2026, manually enter the corrected service span in IoWANS.
EVV compliance required for Home Maintenance Support entries
MCO-enrolled providers who transition members from Chore (S5120) to Home Maintenance Support (S5130) must be fully compliant with entering Home Maintenance services into the applicable EVV system by April 1, 2026.
- Ensure the provider is EVV-capable and entering S5130 Home Maintenance Support visits into the applicable EVV system by 04/01/2026.
Operational Definitions and System Notes
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