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MedicaidReimbursementMedium impact

Ability to Pay Schedule FY23 - Medical Day Care Services Only

Maryland Medicaid·MD · Geriatrics·Provider Transmittal
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid increased medical day care reimbursement rates by 12% effective July 1, 2022, which may now exceed some providers' private pay rates. Providers must use the updated FY2023 Ability to Pay Schedule to calculate payments for private pay participants, ensuring Medicaid payments don't exceed the lesser of per diem rate or customary charges to general public.

Action Required

Action needed
Immediately: Medical day care providers must implement the FY2023 Ability to Pay Schedule for calculating private pay participant fees. Billing team should update payment calculation procedures to ensure Medicaid reimbursement does not exceed provider's customary charges to general public. Review and adjust private pay rates as needed based on income-based percentage schedule provided.