MedicaidReimbursementHigh impact
New Policy for Reimbursement of Medicaid Waiver for Older Adults Assisted Living Services
Maryland Medicaid·MD · Geriatrics·Waiver for Older Adults
Effective date
Sep 1, 2006
We identified it
Jun 20, 2026
Summary
Maryland Medicaid implemented a new policy requiring assisted living facilities to reduce their waiver reimbursement rates by 25% on days when participants also receive medical day care services. Providers must now manually calculate monthly bills using specific daily rates and submit a billing worksheet with claims.
Action Required
By September 1, 2006: Assisted living providers must manually calculate monthly Medicaid waiver claims using new daily rates ($55.74/$41.81 for Level 2, $70.31/$52.73 for Level 3, with/without medical day care). Submit ALF Billing Worksheet with all claims using procedure codes W0216 and W0217. Track participant days with and without medical day care services separately to ensure proper rate application.