Approved State Directed Payment Preprints

A uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering October 1, 2025through September 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment.

Uniform percentage increase for qualified practitioner services at a non-academic medical center and a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$10,714,286.

Uniform percentage increase for qualified practitioner services at a non-academic medical center and a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$9,785,483.

Uniform percentage increase for qualified practitioner services at a non-academic medical center and a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$7,118,634.

Uniform increase established by the State for Behavioral Health Urgent Care (BHUC) for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.

Uniform increase for staff and faculty dental providers at an academic dentistry institution of a public university established by the state for dental services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a risk-based adjustment of up to $3,347,318.

Uniform percentage increase for professional services at an academic medical center for rating periods covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term amount of up to $56,071,432.20.

Minimum fee schedule for dental services for rating period covering October 1, 2024through January 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment amount of up to $27,557.

Minimum fee schedule for dental services for rating period covering February 1, 2025through September 30, 2025, incorporated in the capitation rates through a risk-based rate adjustment amount of up to $58,465.

Minimum fee schedule for primary care services and specialty physician services for rating period covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment of up to $75,353,889.