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
Puerto Rico
Minimum fee schedule established by the state for dental services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
March 18, 2025
Effective Date:
October 1, 2024
Links:
State Rating Period:
October 1, 2024
-
September 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Dental services
Kansas
Uniform percentage increase for inpatient and outpatient hospital services provided by eligible general hospitals, for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $41,000,000.
Approval Date:
March 12, 2025
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Pennsylvania
Value-based purchasing established by the state for eligible nursing facility services for the rating period, January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term up to $15,000,000.
Approval Date:
March 12, 2025
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Tennessee
Uniform dollar increase established by the state for emergency ground ambulance services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term up to $36,579,920.
Approval Date:
March 12, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Massachusetts
Uniform increase established by the state for eligible inpatient hospital services for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates for the Managed Behavioral Health Vendor through a separate payment term of up to $4,601,248.
Approval Date:
March 4, 2025
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
New Hampshire
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:
February 21, 2025
Effective Date:
September 1, 2024
Links:
State Rating Period:
September 1, 2024
-
June 30, 2025
Payment Type:
Value-based payment
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
California
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:
January 17, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
California
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:
January 17, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Dental services
California
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:
January 17, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Kentucky
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:
January 17, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Professional services at an academic medical center