MedicaidReimbursementHigh impact
Fiscal Year 2021 Rate Increase for REM Case Management
Maryland Medicaid·MD·Provider Transmittal
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medicaid's Rare and Expensive (REM) Case Management Program rates are increasing 4% effective January 1, 2021. Four HCPCS procedure codes have new payment rates: Assessment (G9001: $445.86), Level of Care 1 (G9003: $329.22), Level of Care 2 (G9004: $196.22), and Level of Care 3 (G9009: $103.56). Billing teams must update fee schedules immediately to avoid underbilling.
Action Required
Immediately (as of policy date January 7, 2021): Billing team must update all billing software, fee schedules, and claim submission systems with the new REM case management rates for HCPCS codes G9001 ($445.86), G9003 ($329.22), G9004 ($196.22), and G9009 ($103.56). All claims submitted for services provided on or after January 1, 2021, must use these updated rates. Audit any claims submitted between January 1–7, 2021, to identify underbilling and resubmit with correct rates if necessary. Notify all providers and billing staff of the rate changes. Failure to use updated rates will result in underpayment of claims.