MedicaidReimbursementHigh impact
FY24 TCM Rate Increase for DDA TCM Services Including Community Coordination, Waiting List Coordination and Transition Coordination
Maryland Medicaid·MD · Geriatrics, Psychiatry·Provider Transmittal
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medicaid's Developmental Disabilities Administration increased rates for Targeted Case Management (TCM) services by 7.7% effective January 1, 2024. TCM Community Coordination, Waiting List Coordination, and Transition Coordination services now bill at $27.50 per 15-minute unit statewide, with a higher geographic differential rate of $28.96 per 15-minute unit for five Maryland counties (Calvert, Charles, Frederick, Montgomery, and Prince George's).
Action Required
By February 29, 2024: Billing team must update all fee schedules and billing system rate tables to reflect the new TCM service rates. (1) For all DDA TCM services rendered statewide: change base rate to $27.50 per 15-minute unit. (2) For DDA TCM services rendered to participants in Calvert, Charles, Frederick, Montgomery, or Prince George's counties, apply geographic differential rate of $28.96 per 15-minute unit. Ensure billing system applies the correct rate based on participant county of residence. Recalculate and resubmit any TCM claims billed between January 1, 2024 and the system update date using the old rates. Inform all providers and care coordinators providing DDA TCM services of the new rates. Failure to implement correct rates will result in underpayment and potential audit findings.