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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: Allows the Division of Medicaid (DOM) to reimburse for chiropractic se1vices at seventy percent (70%) of the Medicare rate in effect as of Januaiy 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows the Division of Medicaid (DOM) to reimburse for psychiatric therapeutic procedures that are billed using Current Procedural Terminology (CPT) codes at ninety percent (90%) of the Medicare fee schedule in effect on January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows family planning services to be reimbursed ninety percent (90%) of the Medicare fee schedule in effect January 1, 2022 and as may be adjusted each July thereafter.
Summary: Allows the Division of Medicaid (DOM) to reimburse for therapy services at ninety percent (90%) of the Medicare rate in effect on January 1, 2022. and as may be adjusted each July thereafter.
Summary: State Plan Amendment (SPA) 22-0010 allows reimbursement rates for orthotics and prosthetics to be updated annually based on eighty percent (80%) of the Medicare rate.
Summary: This action assures that Maryland’s coverage and reimbursement for COVID-19 vaccines, testing, and treatment during the mandatory American Rescue Plan (ARP) period aligns with section 1905(a)(4)(F) of the Social Security Act.
Summary: This SPA updates reimburse Medicare-covered equipment at 85% of the Medicare rates established on January 1 of each year. This increase is in accordance with the enacted budget approved for FY 2023.
Summary: Implements an 8% rate increase for the Developmental Disabilities Administration Targeted Case Management (DDA TCM) program. In addition, a temporary 10 % rate increase for DDA TCM services using 100 % 9817 generated savings funds for dates of service 10/1/22 through 12/31/22 and on January 1, 2023, the rates will revert back to the rates approved on 07/01/2022.
