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
California
Amendment to a uniform dollar increase established by the state for dental services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment up to $35,407,000.
Approval Date:
August 18, 2026
Effective Date:
January 1, 2026
Links:
Virginia
Uniform percentage increase for inpatient hospital and outpatient hospital services rendered by all non-state government owned hospitals (CRMC and Lake Taylor Transitional Care Hospital) for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $74,610,061.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Uniform percentage increase for physicians employed by or contracted with the non-state government owned general acute care hospital class services for rating periods covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $950,000.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Uniform percentage increase for professional services at an academic medical center for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $274,100,000.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Uniform percentage increase for specialty physician services for rating periods covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $11,050,000.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Indiana
Uniform increase for nursing facility services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $381,073,665.67.
Approval Date:
August 17, 2026
Effective Date:
July 1, 2025
Links:
Texas
Behavioral Health Services (BHS) directed payment program, which is a uniform increase for Community Mental Health Centers and Local Behavioral Health Authorities, for the rating period covering September 1, 2026 through August 31, 2027, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
August 17, 2026
Effective Date:
September 1, 2026
Links:
Colorado
Minimum Fee Schedule for behavioral health outpatient services for the rating periodcovering July 1, 2025 through June 30, 2026, incorporated in the capitation rates througha risk-based rate adjustment up to $522,726,178.
Approval Date:
August 13, 2026
Effective Date:
July 1, 2025
Links:
California
Uniform increase for inpatient and outpatient services provided by eligible network children’s hospitals for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount up to $230,000,000.
Approval Date:
August 13, 2026
Effective Date:
January 1, 2026
Links:
New Jersey
The uniform dollar increase for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screening services for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a risk-based rate adjustment up to $6,832,530.
Approval Date:
August 12, 2026
Effective Date:
July 1, 2026
Links: