Summary

The State of Iowa’s Medicaid program currently operates the Integrated Health Home (IHH).  The proposed changes in the SPA are summarized below:

Integrated Health Home (IHH SPA IA-22-0004)

  • Updated the Comprehensive Transitional Care code from G2065 to 99426 based on the Centers for Medicare and Medicaid Services (CMS) Code updates.
  • Updated the monthly reimbursement rate for tier 6 from $121.14 to $200.97.

Fiscal Impact

The Governor has appropriated additional funding to address the reduction in the non-intensive care management (ICM) reimbursement rate that went into effect July 1, 2021. Effective for dates of service beginning January 1, 2022, IHHs will be reimbursed at the rate of $200.97 for both tier 6 (99490 TG) and tier 8 (99490 U2). IHHs will continue to include the Level II modifier on the claim to indicate an ICM and Non-ICM enrollee.

​​​​​​There is no fiscal impact related to the changes proposed in the IHH SPA.

The changes in the reimbursement amounts are budget neutral.

Public Review and Comments

A copy of this SPA IA-22-0004 and this public notice are posted on the DHS website at: https://dhs.iowa.gov/public-notices/IHH_1.  To reach all stakeholders, non-electronic copies will be made available for review at the DHS Field Offices.

Written comments concerning this notice, or the proposed amendments may be addressed to:  Health Home Program, Iowa Department of Human Services, Iowa Medicaid Enterprise, 1305 East Walnut, Des Moines, Iowa 50319 or may be emailed to:

Healthhomes@dhs.state.ia.us.  Please indicate SPA IA-21-0004 in the subject line of the email.

All comments must be received by: Monday January 31, 2022, at 4:30 PM.