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
North Carolina
Uniform dollar increase and minimum fee schedule for home and community-based services and behavioral health outpatient services established by the state for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 19, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
North Carolina
Minimum fee schedules established by the state for eligible non-state government owned skilled nursing facilities and inpatient behavioral health providers for actual utilization of services for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 18, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Nursing facility services
New Hampshire
Minimum fee schedule for psychiatrists in a state-owned Institutions for Mental Diseases (IMD) established by the state for inpatient, specialty physician services and behavioral health inpatient services for the rating period, July 1, 2023 through August 31, 2024, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
April 18, 2024
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
New Hampshire
Uniform dollar increase for children’s inpatient and outpatient services with recognized children’s hospitals established by the state for the rating period, July 1, 2023 through August 31, 2024, incorporated into the capitation rates through a separate payment term up to $1,668,000.
Approval Date:
April 18, 2024
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
California
Uniform increases established by the state for eligible Designated Public Hospital Systems 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 $2,478,195,000.
Approval Date:
April 17, 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:
Inpatient hospital service
Nursing facility services
Outpatient hospital service
Primary care services
Professional services at an academic medical center
Specialty physician services
Virginia
Uniform increase for inpatient and outpatient services rendered by non-state government owned acute care hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $90,600,000.
Approval Date:
April 17, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Nursing facility services
Outpatient hospital service
Virginia
Uniform increase for physicians affiliated with the practice plans of Virginia’s three allopathic medical schools: University of Virginia, Virginia Commonwealth University, and Eastern Virginia Medical Center, for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $224,900,000.
Approval Date:
April 17, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center
Missouri
Minimum and maximum fee schedules established by the state for inpatient hospital services for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 16, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Missouri
Minimum and maximum fee schedules established by the state for outpatient hospital services for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 16, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Outpatient hospital service
Virginia
The minimum fee schedule established by the state for Durable Medical Equipment providers 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:
April 16, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other