MedicaidReimbursementHigh impact
Fiscal Year 2025 Rates for Nursing Services
Maryland Medicaid·MD · Geriatrics, Pediatrics·EPSDT Nursing Services
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Effective July 1, 2024, Maryland Medical Assistance Program increased nursing services reimbursement rates by 3 percent for EPSDT and Model Waiver Program participants. Billing teams must update their fee schedules for all nursing service codes (T1001, W1002, T1002, T1030, T1003, T1031, W1000, T1021, T1004) to reflect the new rates. Note: Assessment visits (T1001) are excluded from the 3 percent increase.
Action Required
By July 1, 2024 (retroactive if not yet completed): Billing team must update all nursing service fee schedules in the billing system with the new FY2025 rates. Specifically: (1) Update T1001 Assessment to $150.00 (no increase); (2) Update W1002 RN supervisory visit to $79.44 per visit; (3) Update T1002 RN/1 participant to $19.8739 per 15-minute unit; (4) Update T1030 RN/2+ participants to $13.7094 per 15-minute unit; (5) Update T1003 LPN/1 participant to $12.8813 per 15-minute unit; (6) Update T1031 LPN/2+ participants to $8.8854 per 15-minute unit; (7) Update W1000 CNA/HHA/1 participant to $6.8088 per 15-minute unit; (8) Update T1021 CNA/HHA/2+ participants to $4.6979 per 15-minute unit; (9) Update T1004 CNA/HHA/1 participant to $5.6520 per 15-minute unit; (10) Update T1004 with TT modifier CNA/HHA/2+ participants to $3.8983 per 15-minute unit. Begin billing new rates for all Maryland Medicaid nursing services claims dated on or after July 1, 2024. Contact Dawnn Williams at (410) 767-1448 or dawnn.williams@maryland.gov with questions. Failure to update rates may result in underbilling or claim denials.