MedicaidDocumentationMedium impact
Guidance on Private Daily Room Rate Form
Maryland Medicaid·MD · Geriatrics, Palliative Care·Provider Transmittal
Effective date
Jan 15, 2022
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has issued guidance on the Private Daily Room Rate (PDRR) form used in Long Term Care eligibility determinations. Facilities must submit PDRR Change forms when newly enrolling, undergoing a change of ownership, or reporting rate changes. The form must reflect current Genworth survey data, use single room median rates for basic care only, and match rates reported to the Local Department of Human Services.
Action Required
By January 15, 2022 or upon facility enrollment: (1) If your facility is newly enrolling or undergoing a change of ownership, ensure the PDRR form is submitted as part of application documentation to LTCPRU (mdh.ltcmapr@maryland.gov). (2) Verify that PDRR forms reflect current Genworth survey data for your locale and do not exceed/fall below local median rates, or the form will be returned for correction. (3) Ensure only one rate per E&E Vendor ID/level of care is submitted; use single room median rate of combined basic care charges only (exclude recreational activities, vent care, or services above basic room and board). (4) Confirm PDRR rates match amounts reported on DHMH 257 Form to the Local Department of Human Services. (5) Include MA Provider ID and E&E Vendor ID on all forms. (6) For semi-annual or annual updates, submit completed forms to LTCPRU via email with subject line 'PDRR Update'. Billing/administrative staff responsible for provider compliance. Failure to comply will result in rejected forms and delayed eligibility determinations.