Approved State Directed Payment Preprints

Uniform percentage increase for qualified practitioner services at an academic medical center, primary care and specialty physician services, and dental services, as well as a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to$11,858,152.

Uniform percentage increase for primary care services and specialty physician services for the rating period covering October 1, 2025 through September 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $52,159,369.

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, 2026 through December31, 2026, incorporated into the capitation rates through a separate payment term up to$17,675,695.

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, 2026 through December31, 2026, incorporated into the capitation rates through a separate payment term up to$14,237,268.

Uniform dollar increase for ground emergency medical transportation for privately-owned providers, established by the state for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term up to $27,629,600.

Uniform percentage increase for inpatient and outpatient hospital services, and for qualified practitioner services at an academic medical center, and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to $116,141,150.

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, 2026 through December31, 2026, incorporated into the capitation rates through a separate payment term up to$19,570,965.

Maximum Fee Schedule for inpatient hospital services and outpatient hospital services for the rating period covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.

Maximum Fee Schedule for inpatient hospital services and outpatient hospital services for the rating period covering February 1, 2025 through September 30, 2025,incorporated in the capitation rates through a risk-based rate adjustment.

Quality payment and uniform dollar increase for inpatient hospital services, outpatient hospital services, and professional services at an academic medical center 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 $135,747,624.