[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-638756-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-638756-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","in-home-support-services-ihss-guidance-for-developmental-disability-waivers-billing-and-limitations","In Home Support Services (IHSS) Guidance for Developmental Disability Waivers - Billing and Limitations","","Provides guidance for using In Home Support Services (IHSS) as a Medicaid-funded support option through the Developmental Disability Waivers (12VAC30-122-410). Defines IHSS as residential in-home support designed to build skills and ensure health, safety, and welfare, and lists allowable activities such as ADL/IADL skill building, community access, behavior support, medication assistance, monitoring, and transportation. Explains key limitations, including home-only delivery, skill-building requirements, direct-support billing rules, overlap restrictions with other waivers, need for a backup plan, and documentation and billing modifiers for H2014.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/in-home-support-services-ihss-guidance-for-developmental-disability-waivers-billing-and-limitations/638756/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/in-home-support-services-ihss-guidance-for-developmental-disability-waivers-billing-and-limitations/638756.png","ImageObject",300,407,{"name":42,"@type":43},"Cipher","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-09","2026-10-22",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What is IHSS and what is it intended to accomplish?","Question",{"text":62,"@type":63},"IHSS is a residential in-home support service delivered in the individual’s home, family home, or community settings. It is designed to build skills and support health, safety, and welfare, including self-help, socialization, and adaptive skills.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What are the main limitations for IHSS use?",{"text":67,"@type":63},"IHSS is not available in a group residential setting, must include skill building with measurable outcomes, and generally cannot be used to provide general overnight support. It also cannot be billed at the same time as Respite, Personal Assistance (PA), or Companion services.",{"name":69,"@type":60,"acceptedAnswer":70},"How is IHSS billed, and when are modifiers used with H2014?",{"text":71,"@type":63},"IHSS is an hourly service reimbursed based on the number of individuals served. Modifiers UA, U2, and U3 are used depending on whether 1, 2, or 3 individuals are supported by 1 staff member, while H2014 without a modifier may be used when service delivery alternates among multiple authorized individuals with the same agency.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},638756,1793032298,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":96,"preview_page_count":4},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","The purpose of this document is to provide guidance on the use of In Home Support Services (IHSS) as a Medicaid funded support option through the Developmental Disability Waivers  \n12VAC30-122-410. In-home support service (IHSS); In-home support service means a residential service that takes place in the individual's home, family home, or community settings that typically supplement the primary care provided by the individual, family, or other unpaid caregiver and is designed to ensure the health, safety, and welfare of the individual. The individual shall be living in his own home or his family home. This service shall include a skill building component, along with the provision of supports that enable an individual to acquire, retain, or improve the self-help, socialization, and adaptive skills required for successfully living in his community. In-home support service shall be covered in the Family and Individual Supports (FIS) and Community Living (CL) waivers.  \nAllowable activities:  \n\n| 1. Skill Building and routine supports for completion of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) |\n| --- |\n| 2. Skill building, routine, and safety supports for accessing the community |\n| 3. Supporting the Individual in replacing challenging behaviors with positive, accepted behaviorsin the home and in the community |\n| 4. Monitoring health and safety, assistance with taking medications |\n| 5. Transportation to community events |\n| 6. General supports |\n\nLimitations: What this means:  \n\n| 1. IHSS is provided in the Individual’s home or family home | IHSS is not available in a group residential setting. |\n| --- | --- |\n| 2. Supplements the care of the Primary Care Giver | The unpaid primary caregiver remains actively involved in the Individual’s life and provides some natural supports; the Individual may be their own primary caregiver in some situations. |\n| 3. Must include skill building | The purpose of IHSS is to build skills. The plan must include measurable outcomes and progress should be demonstrated. |\n| 4. Cannot be used to provide general support overnight | Billable hours for IHSS are based on direct support. The service is only billable when the Direct Support Professional (DSP) is actively working with the Individual. If the Individual is not provided direct support overnight, the hours are not billable. There must be documented health and/or safety issues that require active monitoring. * |\n| 5. Cannot occur at the same time as another Waiver service | Respite, Personal Assistance (PA) and Companion services are not permitted to be provided/billed atthe same time as IHSS although the Individual may have them authorized for different hours in their Individualized Support Plan (ISP) . |\n| 6. Must have a backup plan | A backup plan is required to ensure the Individual’s safety in case their DSP cannot come for their shift or is late. |\n\n\n| 7. IHSS cannot be used to support others in the home (siblings, children of the Individual) but may be used to support another Individual with IHSS. | IHSS is a 1:1 service unless there is more than one Individual in the home authorized for the service (up to a max of 3 people) and the provider bills the appropriate modifier. |\n| --- | --- |\n| 8. IHSS may be authorized for brief periods to provide 24-hour support. | With justification, IHSS may be provided 24 hours fora short time to provide support due to a significant short-term event. * |\n\nBilling for IHSS (H2014)  \nIHSS is an hourly service and reimbursed according to the number of Individuals served. The modifier is used in conjunction with H2014 according to the proposed staffing:  \n\n| UA-used to bill when 􀃆 | 1 Individual with 1 staff |\n| --- | --- |\n| U2-used to bill when 􀃆 | 2 Individuals supported by 1 staff |\n| U3-used to bill when 􀃆 | 3 Individuals supported by 1 staff |\n| H2014 (no modifier)-this is how the service is authorized. | If more than one Individual residing in the home has a","cbCaicBuKMx74HTf","https://ap.wps.com/l/cbCaicBuKMx74HTf","pdf",185325,"English","# Purpose and definition of IHSS\n## Covered waivers\n## Allowable activities\n# Limitations and operational requirements\n## Home-only setting\n## Primary caregiver relationship\n## Skill-building and measurable outcomes\n## Overnight and timing restrictions\n## Other waiver service overlap\n## Backup plan requirement\n## 1:1 service rules and multi-person limits\n## Brief 24-hour support\n# Billing guidance for IHSS (H2014)\n## Hourly reimbursement and modifiers\n## When to use UA/U2/U3\n## Examples of H2014 without a modifier\n# Documentation requirements","[{\"question\":\"What is IHSS and what is it intended to accomplish?\",\"answer\":\"IHSS is a residential in-home support service delivered in the individual’s home, family home, or community settings. It is designed to build skills and support health, safety, and welfare, including self-help, socialization, and adaptive skills.\"},{\"question\":\"What are the main limitations for IHSS use?\",\"answer\":\"IHSS is not available in a group residential setting, must include skill building with measurable outcomes, and generally cannot be used to provide general overnight support. It also cannot be billed at the same time as Respite, Personal Assistance (PA), or Companion services.\"},{\"question\":\"How is IHSS billed, and when are modifiers used with H2014?\",\"answer\":\"IHSS is an hourly service reimbursed based on the number of individuals served. Modifiers UA, U2, and U3 are used depending on whether 1, 2, or 3 individuals are supported by 1 staff member, while H2014 without a modifier may be used when service delivery alternates among multiple authorized individuals with the same agency.\"}]","In Home Support Services (IHSS) Guidance for Developmental Disability Waivers - Billing and Limitations | PDF",1792699268]