MedicaidReimbursementHigh impact
Fiscal Year 2025 Rates for Community First Choice and Community Personal Assistance Services
Maryland Medicaid·MD · Geriatrics, Occupational Therapy, Physical Therapy +1 more·Community First Choice
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program is increasing reimbursement rates by 3% for Community First Choice and Community Personal Assistance Services effective July 1, 2024. Billing teams must update fee schedules in their systems to reflect new rates for 14 service codes. Note that certain codes (Accessibility Adaptations, Technology, Personal Emergency Response Systems, and Transition Services) are exempt from the increase.
Action Required
By July 1, 2024: Billing team must update all fee schedules in the billing system for Community First Choice and Community Personal Assistance Services. Specifically: (1) Update rates for the 20 affected HCPCS codes listed above to reflect the 3% increase or new rates provided in the policy; (2) Verify that codes W5513, W5514, W5510, W5511, and W5517 maintain their previous rates (not subject to increase per COMAR 10.09.84.24); (3) Configure billing software to apply new rates only to services rendered on or after July 1, 2024; (4) Audit all claims submitted after the effective date to ensure correct rates are applied. Failure to update rates may result in underbilling or claim denials if rates do not match Maryland Medical Assistance Program expectations. Contact Lisa Toland at (410) 767-5792 or lisa.toland@maryland.gov with rate questions.