MedicaidReimbursementHigh impact
Fiscal Year 2025 Rates for the Developmental Disabilities Administration Targeted Case Management Services
Maryland Medicaid·MD · Occupational Therapy, General Practice·Developmentally Disabled Individuals
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Effective July 1, 2024, Maryland's Developmental Disabilities Administration (DDA) Targeted Case Management (TCM) services received a 3% rate increase to $28.33 per 15-minute unit. Additionally, a geographic differential rate of $29.83 per 15-minute unit applies to services in five Maryland counties (Calvert, Charles, Frederick, Montgomery, and Prince George's). This affects Community Coordination, Waiting List Coordination, and Transition Coordination services for Medicaid beneficiaries.
Action Required
By July 1, 2024 (or immediately if date has passed): Billing team must update rate tables in billing system to reflect new TCM rates: $28.33 per 15-minute unit for standard areas and $29.83 per 15-minute unit for Calvert, Charles, Frederick, Montgomery, and Prince George's counties in Maryland. Update claim submission logic to apply geographic differential rates based on participant residence. Verify all pending and future TCM claims use correct rates. Failure to update rates will result in underbilling (if using old rates) or claim denials (if rates don't match state requirements). Contact Denise Farmer (denise.farmer@maryland.gov) or Robert White (robert.white2@maryland.gov) for clarification.