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Fiscal Year 2024 Rates for Community First Choice and Community Personal Assistance Services

Maryland Medicaid·MD · Geriatrics, Occupational Therapy, Physical Therapy +2 more·Provider Transmittal
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Effective January 1, 2024, Maryland Medical Assistance Program increased rates by 8% for Community First Choice and Community Personal Assistance Services. Most service codes increased (Consumer Training, Personal Assistance Services, Supports Planning, Nurse Monitoring), while Accessibility Adaptations, Technology, Personal Emergency Response Systems, and Transition Services were excluded from the increase per COMAR 10.09.84.24. Billing teams must update fee schedules in billing systems to reflect new rates for all services rendered on or after January 1, 2024.

Action Required

Action needed
By December 31, 2023: Billing team must update all fee schedules in the billing system for both Community First Choice (W5513, W5514, W5518, W5512, W5516, W5519, W5521, W5532, W5533, W5510, W5511, W5523, W5524, W5525, W5517, W5522) and Community Personal Assistance Services (W5527, W5528, W5526, W5524, W5525, W5529) programs to reflect the new January 1, 2024 rates. Update rate tables to reflect the 8% increase for applicable services. NOTE: Do NOT increase rates for W5513 (Accessibility Adaptations), W5514 (Technology), W5510/W5511 (Personal Emergency Response Systems), or W5517 (Transition Services) as these are excluded from the statutory increase. Configure billing system to prevent billing old rates for services rendered on or after January 1, 2024. Verify all 20 affected procedure codes are updated before the effective date. Failure to implement new rates will result in underbilling for eligible services.

Affected Billing Codes

W5513
W5514
W5518
W5512
W5516
W5519
W5521
W5532
W5533
W5510
W5511
W5523
W5524
W5525
W5517
W5522
W5527
W5528
W5526
W5529