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MedicaidReimbursementHigh impact

Fiscal Year 2023 Rate Increase for Nursing Services

Maryland Medicaid·MD · Geriatrics, Palliative Care, Occupational Therapy +1 more·Provider Transmittal
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Effective July 1, 2022, Maryland Medical Assistance Program increased nursing services rates by 12% for Medicaid participants, including statutory FY2023 increases, Senate Bill 290 funding, and a temporary 4% American Rescue Plan Act increase. All nursing, certified nursing assistant, and home health aide service codes have new reimbursement rates that must be updated in billing systems immediately.

Action Required

Action needed
URGENT - By July 1, 2022 (retroactive): Billing team must immediately update all nursing services fee schedules in the billing system with the new rates provided in the attached fee schedule. Update rates for all affected procedure codes (T1001, W1002, T1002, T1030, T1003, T1031, W1000, T1021, T1004) to reflect the 12% increase. Verify that the T1004 code with TT Modifier is configured separately at the reduced rate. Note: Assessment visits (T1001) are NOT subject to the rate increase and should retain previous rates. Communicate changes to all billing staff, providers, and nursing services coordinators. Configure billing software to apply the 4% temporary American Rescue Plan Act increase only for FY2023 (through June 30, 2023). Failure to update rates will result in underbilling and revenue loss. Contact Dawnn Williams at (410) 767-1448 or dawnn.williams@maryland.gov with questions.

Affected Billing Codes

T1001
W1002
T1002
T1030
T1003
T1031
W1000
T1021
T1004