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
Rhode Island
The uniform increase established by the state for nursing facility services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
November 27, 2024
Effective Date:
October 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Washington
Uniform increase established by the state for behavioral health inpatient and outpatient services delivered by eligible providers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a through a risk-based adjustment.
Approval Date:
November 27, 2024
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:
Behavioral health inpatient service
Behavioral health outpatient services
Washington
Uniform increase established by the state for behavioral health inpatient and behavioral health outpatient services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
November 27, 2024
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:
Behavioral health inpatient service
Behavioral health outpatient services
District of Columbia
The maximum fee schedule for outpatient hospital services established by the state for the rating period, October 1, 2023 through September 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
November 27, 2024
Effective Date:
October 1, 2023
Links:
State Rating Period:
October 1, 2023
-
September 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Outpatient hospital service
No state
The Integrated Care Incentive proposal for inpatient and outpatient hospital services at non-federal, non-state-owned, public hospitals for the rating period covering April 1, 2023 through December 31, 2024 through a separate payment term of up to $86.8 million for April 1, 2023 through December 31, 2023 and $148.8 million for January 1, 2024 through December 31, 2024.
Approval Date:
November 26, 2024
Effective Date:
April 1, 2023
Links:
State Rating Period:
April 1, 2023
-
December 31, 2024
Payment Type:
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Massachusetts
The Behavioral Health Quality Incentive proposal for non-federal, non-state-owned, public hospitals for behavioral health inpatient and outpatient services for the rating period covering January 1, 2023 through December 31, 2024 incorporated in the capitation rates through a separate payment term of up to $60 million for January 1, 2023 through December 31, 2023 and $72 million for January 1, 2024 through December 31, 2024.
Approval Date:
November 26, 2024
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Multiple Rating Period
Provider Class:
Behavioral health inpatient service
Behavioral health outpatient services
Massachusetts
The minimum fee schedule for behavioral health outpatient services, 24 hour diversionary substance use disorder services and behavioral health diversionary services including the Program for Assertive Community Treatment (PACT), Recovery Coach (RC) and Recovery Support Navigator (RSN) Services, Community Based Acute Treatment (CBAT), Acute Treatment Services (ATS), Clinical Stabilization Services (CSS), and Residential Rehabilitation Services (RRS) for the rating period covering January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
November 26, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
Pennsylvania
The alternative minimum fee schedule established by the state for qualifying providers under specific American Society of Addition Medicine (ASAM) levels of care who provided substance use disorder (SUD) treatment 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:
November 26, 2024
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:
Behavioral health inpatient service
Behavioral health outpatient services
Pennsylvania
The minimum fee schedule for providers involved in the Integrated Community Wellness Center (ICWC) 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:
November 26, 2024
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
Indiana
A uniform increase for nursing facilities established by the state based on Medicaid nursing facility utilization and quality performance metrics for the rating period July 1,2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $180.7 million.
Approval Date:
November 26, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services