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MedicaidReimbursementMedium impact

Fiscal Year 2019 Rates for the Home and Community-Based Options Waiver and Increased Community Services (ICS) Programs

Maryland Medicaid·MD · Geriatrics, Family Medicine, General Practice·Provider Transmittal
Effective date
Jul 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland updated payment rates for Home and Community-Based Options Waiver and Increased Community Services programs effective July 1, 2018. The policy establishes specific reimbursement rates for services including case management ($63.75/hour), medical day care ($79.84/day), assisted living services, and behavior consultation ($67.97/hour).

Action Required

Action needed
Billing team must verify current payment rates in billing system match the published rates for Maryland Medicaid waiver services. Update fee schedules for procedure codes W0199, W5524, W5525 ($63.75/hour), W0212, W0208, W1724 ($67.97/hour), S5102 ($79.84/day), and assisted living codes W0226-W0229, W0221, W1723 with their respective daily rates. Ensure compliance with billing limitations specified in COMAR 10.09.54 and 10.09.81.

Affected Billing Codes

W0199
W5524
W5525
W0212
W0208
S5102
W0226
W0227
W0228
W0229
W0221
W1723
W1724