Indiana Attendant Care Family Caregiver Pay (2026)

Indiana Attendant Care, a service in the state's Medicaid home-care waivers, pays a family caregiver such as an adult child for hands-on help with a relative's daily activities at home.1 Indiana Attendant Care pay runs through an agency or a self-directed budget, and a spouse can be paid for Attendant Care only in narrow nursing-care cases.1,2 To start, request a level-of-care assessment from Maximus at 1-833-597-2777.3

Who Can Be the Paid Attendant?

Attendant Care (ATTC) is a service in Indiana Medicaid waivers including PathWays for Aging, the Health and Wellness waiver and the Traumatic Brain Injury (TBI) waiver.5,6 The PathWays amendment approved effective Aug. 1, 2026 lets relatives be paid for Attendant Care "including participant-directed ATTC services."1

Guardian row: Indiana Code 12-10-17.1-10. Power-of-attorney row: FSSA's 2024 guidance.1

When a Spouse Can Be Paid

Indiana's July 2024 bar on paying spouses for Attendant Care now has a narrow exception. Under PathWays, a spouse can be paid for Attendant Care only when all of these hold:1

• Extraordinary care: beyond what a spouse would ordinarily do, for intensive nursing needs your spouse can't meet independently, under an interdisciplinary team's supervision: continuous ventilator care, tracheostomy care, total parenteral nutrition, or comparable nursing services FSSA approves.
• Through an agency: you work for or contract with an FSSA-approved agency, and Indiana pays only the agency. Indiana Code 12-10-17.1-10(b) bars paying a spouse for self-directed care.
• Hours: a paid spouse's Attendant Care is capped at 40 hours a week in total for the PathWays participant.

FSSA's bulletin BT202603 counts comparable nursing care as at least two of: frequent or complex seizures needing monitoring, closely monitored IV medication, ongoing complex wound care, or noncontinuous ventilator management. If you're the spouse doing this care daily, ask the case manager or service coordinator to send FSSA the request with a physician's Form 450B; our Indiana caregiver programs guide covers the approvals it needs.6

PathWays can also pay a spouse through Structured Family Caregiving when its stated conditions are met; see getting paid to care for your spouse in Indiana.6

How Many Hours Indiana Attendant Care Pays a Family Caregiver

Under the PathWays amendment, Attendant Care, Home and Community Assistance (HCA) and Skilled Respite paid to a relative or legal guardian (not a spouse) "must not exceed forty (40) hours per week across all services for each paid relative/legal guardian caregiver." The PathWays amendment's Attendant Care limit still reads as 40 hours of Attendant Care alone, but FSSA says it changed the relative-pay section "to clarify the intended policy," so plan around the combined 40.1

On the Health and Wellness and TBI waivers, for dates of service from Jan. 1, 2026, the cap is 40 hours a week of Attendant Care alone per paid relative or legal guardian; a posted Health and Wellness amendment adding the combined cap has only a proposed effective date.6

These are ceilings; whether a relative provides the services is decided in the person-centered service plan (PCISP) and reviewed periodically.1

Agency or Self-Directed: How the Money Reaches You

Indiana pays a relative only through an FSSA-approved provider agency or, when the service is participant-directed, the financial management services vendor.1

Since Jan. 1, 2026, PathWays, Health and Wellness and TBI members can self-direct Attendant Care, Respite Care Services and Home and Community Assistance, authorized per hour against a self-directed budget. Participant-Directed Attendant Care (PDAC) and the other older options ended Dec. 31, 2025.2

What Indiana Attendant Care Family Caregiver Pay Looks Like

The $34.36 an hour FSSA's February 2024 comparison lists for Attendant Care, repeated in Indiana Medicaid's July 2025 provider bulletin, is what Indiana pays the agency. Since July 1, 2025, an Indiana Attendant Care agency must spend at least 70% of its Attendant Care rate on direct-service compensation, but FSSA counts wages, employee-related expenses and agency administration and overhead inside that 70%, so ask the agency what share you'll be paid.7

Does Your Parent Qualify?

To get Attendant Care through PathWays, your parent must:5

• be 60 or older and on Medicaid in a full-coverage aged, blind or disabled category
• need nursing facility level of care
• have monthly income of up to $2,982, counting only their own income (effective March 1, 2026)5
• have assets of no more than $2,000 single or $3,000 married5

Expect a wait: the PathWays waiver has a waiting list. After people leaving a nursing facility, a hospital or Indiana's CHOICE program, FSSA invites people by their level-of-care assessment date, so request it early.8

How to Start Getting Paid

Is Attendant Care Pay Taxable?

Under IRS Notice 2014-7, pay under a state 1915(c) waiver such as PathWays is excludable from federal gross income only when you give the care in your own home and the person lives there too.9 For separate homes and payroll taxes, see whether Medicaid caregiver pay is taxable.

Learn More

Find personalized help getting paid as an Indiana Attendant Care attendant at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.