MedicaidReimbursementHigh impact
Fiscal Year 2027 Rates for the Developmental Disabilities Administration Targeted Case Management Services
Maryland Medicaid·MD · Geriatrics, Palliative Care·Provider Transmittal
Effective date
Jul 1, 2026
We identified it
Jul 17, 2026
Summary
Maryland Medicaid Developmental Disabilities Administration is reducing Targeted Case Management (TCM) service rates by 2% effective July 1, 2026. Comprehensive Assessment rate drops to $441.00 per assessment, and TCM coordination services decrease to $27.76 per 15-minute unit statewide, with a higher geographic differential rate of $29.76 per 15-minute unit for five designated Maryland counties (Calvert, Charles, Frederick, Montgomery, Prince George's).
Action Required
By June 30, 2026: Billing team must update fee schedules in billing software for all Maryland Medicaid DDA Targeted Case Management claims. (1) Update Comprehensive Assessment reimbursement to $441.00 per assessment. (2) Update TCM Community Coordination, Waiting List Coordination, and Transition Coordination rates to $27.76 per 15-minute unit for all Maryland counties. (3) Configure billing system to apply geographic differential rate of $29.76 per 15-minute unit for services provided to participants in Calvert, Charles, Frederick, Montgomery, and Prince George's counties. (4) Verify all affected claims process correctly under new rates starting July 1, 2026. (5) Communicate rate changes to clinical staff and DDA case management providers in your network. Failure to update rates may result in overpayment denials or claim adjustments by Maryland Medicaid.