MedicaidReimbursementHigh impact
Fiscal Year 2023 Rates for Brain Injury Waiver Services
Maryland Medicaid·MD · Occupational Therapy, Physical Therapy, Geriatrics +1 more·Provider Transmittal
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
The Maryland Medical Assistance Program increased reimbursement rates for Brain Injury Waiver services by 11.25% effective July 1, 2022. This includes a statutory rate increase, additional funding from Senate Bill 290, and a temporary 4% increase from the American Rescue Plan Act. Billing teams must update fee schedules in their system to reflect the new rates for all covered services.
Action Required
By July 1, 2022 (or immediately if claims are being submitted after this date): Billing team must update all fee schedules and billing system rates for Brain Injury Waiver services. Replace the following rates in the billing software: W0037 to $276.59/day, W0038 to $366.22/day, W0039 to $506.64/day, W0054 to $71.41/day, W0055 to $124.57/day, W0056 to $175.24/day, W0057 to $42.36/day, W0058 to $71.41/day, W0059 to $175.24/day, and W0060 to $8.6553 per 15 minutes. Verify all claims submitted on or after July 1, 2022 are using the updated rates. Contact Alisa Jones at (410) 767-3014 or alisa.jones@maryland.gov with billing questions. Failure to update rates will result in underbilling and revenue loss.