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MedicaidReimbursementHigh impact

Fiscal Year 2023 Rate Increase for CFC and CPAS

Maryland Medicaid·MD · Geriatrics, Physical Therapy, Occupational Therapy +2 more·Provider Transmittal
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medical Assistance Program is increasing reimbursement rates for Community First Choice and Community Personal Assistance Services by 12% effective July 1, 2022. This increase includes statutory FY2023 rates, Senate Bill 290 supplemental funding, and a temporary 4% American Rescue Plan Act increase for home and community-based services. Billing teams must update fee schedules in their systems to reflect new rates for all affected procedure codes.

Action Required

Action needed
By July 1, 2022: Billing team must update all fee schedules in the billing system for Community First Choice and Community Personal Assistance Services. Replace all previous rates with the new rates specified in the attached fee schedules for procedure codes W5513, W5514, W5518, W5512, W5516, W5519, W5521, W5532, W5533, W5510, W5511, W5523, W5524, W5525, W5517, W5522, W5527, W5528, W5526, and W5529. Ensure providers are notified of the rate increases. Note that certain codes (W5513, W5514, W5510, W5511, W5517) are NOT subject to the statutory increase per COMAR 10.09.84.24. Failure to update rates will result in underbilling and revenue loss. Contact Lisa Toland at (410) 767-5792 or Lisa.Toland@maryland.gov with questions.

Affected Billing Codes

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