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MedicaidReimbursementHigh impact

Fiscal Year 2023 Rates for Autism Waiver Services

Maryland Medicaid·MD · Pediatrics, Psychiatry·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 rates for Autism Waiver Services by 12 percent across multiple service codes. This includes a statutory rate increase for FY 2023 and a temporary 4 percent increase under the American Rescue Plan Act. Billing teams must update all rate tables in their billing systems to reflect the new payment rates for services provided on or after July 1, 2022.

Action Required

Action needed
By July 1, 2022: Billing team must update all rate tables in the billing system for the 11 affected procedure codes (Z9300, W9304, Z9301, W9305, W9306, W9307, W9308, W9311, W9314, W9315, W9320) to reflect the new FY 2023 payment rates listed in the attached fee schedule. Update claim submission templates and verification tools to reflect increased rates. Verify that billing software applies the new rates only to services rendered on or after July 1, 2022. Communicate updated rates to all Autism Waiver providers in the organization. Note: Do not bill provider travel time, and ensure all other COMAR 10.09.56 billing limitations remain in effect. Failure to update rates may result in underbilling or claim processing delays.

Affected Billing Codes

Z9300
W9304
Z9301
W9305
W9306
W9307
W9308
W9311
W9314
W9315
W9320