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MedicaidReimbursementHigh impact

Fee-For-Service Hospital Day Limits

Maryland Medicaid·MD·Hospital
Effective date
Jul 1, 2004
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid is reducing hospital day limits from 105% to 100% of average length of stay by diagnosis related groups (DRGs), effective July 1, 2004. This policy change affects reimbursement for hospital stays that exceed the new, lower day limits for each DRG category.

Action Required

Action needed
By July 1, 2004: Billing teams at Maryland hospitals must update their systems to reflect the new reduced day limits for each DRG category (attached list shows specific day limits per DRG). Review current inpatient cases to ensure compliance with new limits. Contact Linda Lee-Green at 410-767-1722 for non-psychiatric services or Richard Bandelin at 410-402-8453 for psychiatric services with questions. Cases exceeding new day limits may require additional authorization or face reimbursement reductions.