MedicaidReimbursementMedium impact
Amendment to COMAR 10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Private Duty Nursing
Maryland Medicaid·MD · Pediatrics, General Practice·EPSDT Nursing Services
Effective date
Jul 1, 2006
We identified it
Jun 20, 2026
Summary
Maryland Medicaid increased private duty nursing reimbursement rates from $28.20 to $31.00 per hour effective July 1, 2006, and changed billing from half-hour to 15-minute units ($7.75 for one participant, $5.35 for multiple participants). This policy establishes a methodology for annual rate adjustments based on Consumer Price Index.
Action Required
Billing team must update private duty nursing service billing to use 15-minute units instead of half-hour units at new rates: $7.75 per 15 minutes for one participant and $5.35 per 15 minutes for multiple participants in same residence. Update billing system fee schedules and ensure Maryland Medicaid claims reflect new unit structure.