MedicaidReimbursementHigh impact
Fiscal Year 2025 Rates for Brain Injury Waiver
Maryland Medicaid·MD · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Waiver for Adults with Brain Injury (TBI)
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Effective July 1, 2024, the Maryland Medical Assistance Program increased reimbursement rates for Brain Injury Waiver services by 3% across all service levels including Residential Habilitation, Day Habilitation, Supported Employment, and Individual Support Services. Billing teams must update fee schedules in their systems and begin applying new rates for all claims dated on or after July 1, 2024.
Action Required
By July 1, 2024: Billing team must update all billing system fee schedules for Maryland Medical Assistance Program Brain Injury Waiver services with the new rates for procedure codes W0037, W0038, W0039, W0054, W0055, W0056, W0057, W0058, W0059, W0060, and W0061. Update encounter forms, superbill templates, and any fee lookup tables to reflect the 3% rate increases. Verify that billing software is configured to apply new rates only to claims with service dates on or after July 1, 2024. Notify all providers and administrative staff of the rate changes. Failure to apply correct rates may result in underbilling and revenue loss. Contact Jeronica Baldwin (410-767-5206, jeronica.baldwin@maryland.gov) or Elena Janetopoulos (240-761-1344, elena.janetopoulos@maryland.gov) for questions.