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Fiscal Year 2025 Rates for Autism Waiver Services

Maryland Medicaid·MD · Pediatrics, Psychiatry, Occupational Therapy +1 more·Waiver for Children with Autism Spectrum Disorder
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Effective July 1, 2024, Maryland Medical Assistance Program increases reimbursement rates by 3% for Autism Waiver Services under COMAR 10.09.56. All service procedure codes receive rate increases except Environmental Accessibility Adaptation (W9320), which remains at $2,104 per 36-month period. Billing teams must update fee schedules in their systems to reflect new rates for services rendered on or after July 1, 2024.

Action Required

Action needed
By July 1, 2024: Billing team must update all rate schedules in billing software for the 11 Autism Waiver Service codes listed above. Update fee schedules to reflect: Z9300 ($315.58), W9304 ($315.58), Z9301 ($631.23), W9305 ($631.23), W9306 ($11.9527 per 15-min), W9307 ($9.5611 per 15-min), W9308 ($11.9527 per 15-min), W9311 ($39.2399 per 15-min), W9314 ($9.3442 per 15-min), W9315 ($39.2399 per 15-min), and W9320 ($2,104 per 36-month period). Verify billing system will apply new rates only to claims dated on or after July 1, 2024. Communicate changes to all billing staff and providers. Note: Travel time remains non-reimbursable per COMAR 10.09.56. Contact Jeronica Baldwin (410-767-5206) or Lina Mak (410-767-0046) with questions.

Affected Billing Codes

Z9300
W9304
Z9301
W9305
W9306
W9307
W9308
W9311
W9314
W9315
W9320