MedicaidReimbursementHigh impact
Fiscal Year 2025 Rates for Home and Community-Based Options Waiver and Increased Community Services
Maryland Medicaid·MD · Geriatrics, Physical Therapy, Speech Therapy +1 more·Home and Community-Based Options Waiver
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program is increasing reimbursement rates by 3% for Home and Community-Based Options Waiver (HCBOW) and Increased Community Services (ICS) programs effective July 1, 2024. Billing teams must update fee schedules in their systems to reflect the new rates for all affected service codes to ensure accurate claim submissions and reimbursement.
Action Required
By July 1, 2024: Billing team must update all fee schedules in the billing system to reflect the new 3% increased rates for the 14 affected service codes. Update internal rate reference documents and provider fee schedule tables. Verify that claims submitted on or after July 1, 2024 reflect the new rates listed in the policy attachment (e.g., W0199 now $23.2645 per 15-minute unit, S5102 now $116.59 per day). Communicate the rate changes to all providers billing under HCBOW and ICS programs. Claims billed with outdated rates may be subject to underpayment or denial.