MedicaidReimbursementHigh impact

Proposed HealthChoice Amendments

Q: Who is affected by this change?

This affects Maryland Medicaid Physical Therapy, Occupational Therapy, Speech Therapy providers in MD on Medicaid plans.

Maryland Medicaid·MD · Physical Therapy, Occupational Therapy, Speech Therapy·Managed Care Organizations

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

Maryland Medicaid managed care organizations will receive an 8.5% rate increase totaling $107 million, with changes to payment schedules, benefit limitations clarifying MCOs are not responsible for outpatient PT/OT/speech therapy unless part of inpatient or home health services, and updated HIPAA compliance payment requirements.

Action Required

Action needed

By November 18, 2002: Review proposed amendments affecting Maryland Medicaid managed care reimbursement. Billing team should prepare for rate increases and updated benefit limitations that exclude standalone PT, OT, and speech therapy services from MCO responsibility unless provided as part of inpatient hospital or home health services. Update billing procedures to reflect new payment schedules and HIPAA compliance requirements once finalized.

Related policy hubs

Maryland Medicaid policies MD policy changes Physical Therapy Occupational Therapy Speech Therapy