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MedicaidReimbursementMedium impact

FY 2015 Community First Choice Program Rates

Maryland Medicaid·MD · Occupational Therapy, Physical Therapy·Community First Choice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland's Community First Choice Program has established specific reimbursement rates for home and community-based services effective July 1, 2014. This policy sets payment rates for various W-codes including personal assistance services, environmental assessments, home delivered meals, and other community support services.

Action Required

Action needed
Billing team must update reimbursement rates for all Community First Choice Program W-codes in billing system. Verify current rates match the published fee schedule: W5519 at $4.12 per 15-minute unit, W5520 at $3.145 per 15-minute unit, W5512 at $407.26 per assessment, and other specified rates. Note combined $15,000 three-year limit for W5513 and W5514 services. Review COMAR 10.09.84 for additional billing limitations.

Affected Billing Codes

W5510
W5511
W5512
W5513
W5514
W5516
W5517
W5518
W5519
W5520
W5521
W5523
W5524
W5525