Approved State Directed Payment Preprints

Uniform Dollar Increase for inpatient hospital 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 $123,350,308.

Population-based payment established by the state for primary care services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.

Uniform dollar increase established by the state for inpatient hospital services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a separate payment term up of to $123,350,308.

Minimum fee schedule established by the state for specialty physician services and behavioral health outpatient services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.

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.

Minimum fee schedule established by the state for eligible specialty physician services that are covered at 100% of Medicare and eligible behavioral health outpatient services that are covered at 80% of Medicare consistent with the requirements of the
Consolidated Appropriations Act of 2023 for the rating period covering October 1, 2023 through September 30, 2024 incorporated in the capitation rates through a risk-based adjustment.
 

Minimum fee schedule established by the state for primary care services and laboratory services that are covered at 100% of Medicare consistent with the requirements of the Consolidated Appropriations Act of 2023 for the rating period covering October 1, 2023through September 30, 2024 incorporated in the capitation rates through a risk-based adjustment.

Minimum fee schedule established by the state for primary care services and laboratory services that are covered at 75% of Medicare consistent with the requirements of the Consolidated Appropriations Act of 2023 for the rating period covering October 1, 2023through September 30, 2024 incorporated in the capitation rates through a risk-based adjustment.

Uniform dollar increase for inpatient hospital services at qualifying short-term acute care (STAC) hospitals for the rating period covering October 1, 2023 through September 30, 2024 incorporated in the capitation rates through a separate payment term of up to $135,978,450.

Minimum Fee Schedule for professional and facility urgent care centers (CDTs) established by the state for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a risk-based adjustment.