The Centers for Medicare & Medicaid Services (CMS) Medicaid managed care regulations at 42 C.F.R. § 438 govern how states may direct plan expenditures in connection with implementing delivery system and provider payment initiatives under Medicaid managed care contracts. CMS began reviews of state directed payment arrangements beginning with contract rating periods on or after July 1, 2017. For more information on state directed payments, please visit our Guidance Page. Persons with disabilities having problems accessing the Preprint PDF files may call 410-786-0429 for assistance.
Approved State Directed Payment Preprints
Results
Displaying 1 - 10 of 667
SDP Identifier:: NH_VBP_BHO_New_20240901-20250630
State: New Hampshire
Summary:
The value-based payment for eligible community mental health centers established by the state for behavioral health outpatient services for the rating period September 1, 2024through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment up to $5,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_Oth1_Renewal_20250101-20251231
State: California
Summary:
Uniform dollar increase established by the state for developmental screening services for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_Oth2_Renewal_20250101-20251231
State: California
Summary:
Uniform dollar increase established by the state for Family Planning services for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_D_Renewal_20250101-20251231
State: California
Summary:
Uniform dollar increase established by the state for dental services for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Dental services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: KY_Fee.VBP_IPH.OPH.AMC_Amend_20250101-20251231
State: Kentucky
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services and professional services at an academic medical center for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment; Value-based payment established by the state for inpatient and outpatient hospital services and professional services at an academic medical center for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $404,228,342.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service, Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_IPH.OPH.BHI.BHO_Renewal_20250701-20260630
State: North Carolina
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term of up to $6,458,454,629.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: OH_VBP_BHO_New_20250101-20251231
State: Ohio
Summary:
Population-based payment established by the state for Mobile Response and Stabilization Services (MRSS) program providers for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term up to $36,650,413.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_IPH.OPH_Renewal_20241001-20250930
State: Michigan
Summary:
Uniform increase established by the state for inpatient and outpatient hospital services for the rating period covering October 1, 2024 through September 30, 2025 incorporated into the capitation rates through a separate payment term up to $5,068,237,933.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_VBP_PC_New_20230701-20250630
State: North Carolina
Summary:
Integrated Care for Kids (InCK) value based payment model for eligible primary care service providers for the rating periods covering July 1, 2023 through June 30, 2025, incorporated into the capitation rates through a risk based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Primary care services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WV_Fee_OTH1_Renewal_20240701-20250630
State: West Virginia
Summary:
The Uniform Increase for eligible Acute Care Hospitals established by the state for Specialty Physician Services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $40,347,612.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
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