MedicaidBilling CodesHigh impact
Revised Nursing Facility Assessment and Reimbursement Handbook
Maryland Medicaid·MD · Geriatrics, Physical Therapy, Occupational Therapy +1 more·Nursing Home
Effective date
Oct 1, 2004
We identified it
Jun 20, 2026
Summary
Maryland's Medical Assistance Program (Medicaid) updated its nursing facility assessment and reimbursement handbook, introducing new revenue codes effective October 1, 2004. The handbook defines criteria for reimbursement levels based on activities of daily living and establishes billing requirements for special services, additional services, and therapy services in nursing facilities.
Action Required
Immediately: Nursing facility billing teams must update billing systems with new revenue codes effective October 1, 2004. For dates of service prior to October 1, 2004, continue using four-digit revenue codes plus five-digit procedure codes as specified in Maryland Medicaid UB-92 billing instructions. Update encounter forms and billing software to reflect the new reimbursement levels (Light, Moderate, Heavy, Heavy Special) and corresponding revenue codes. Staff must complete Maryland Monthly Assessment forms to document ADL dependencies and ancillary services for proper reimbursement determination.