MedicaidAdministrativeMedium impact
Payment Responsibilities for Addiction Services in ICF-As
Maryland Medicaid·MD · Psychiatry, Pediatrics·Managed Care Organizations
Effective date
Feb 23, 1998
We identified it
Jun 20, 2026
Summary
For Medical Assistance recipients under age 21 admitted to ICF-A (Intermediate Care Facilities - Alcoholic) facilities, payment responsibility splits between the Maryland Medical Assistance Program and Managed Care Organizations (MCOs) based on enrollment timing. The state pays for services up to MCO enrollment, then the MCO becomes responsible for the remaining approved stay.
Action Required
Billing team must verify MCO enrollment dates for Medical Assistance recipients under 21 in ICF-A facilities. Bill Maryland Medical Assistance Program for services prior to MCO enrollment and bill the appropriate MCO for services after enrollment date. Update billing workflows to check enrollment status before submitting claims for addiction services in ICF-A settings.