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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: This plan amendment incorporates the 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Therapy fee schedule. Codes that
are being added are being priced using a comparable methodology to other codes in the same or similar category. These changes are being made to ensure this fee schedule remains compliant with the Health
Insurance Portability and Accountability Act (HIPAA).
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase base payments to nursing homes
Summary: Revises the Medical Clinic, Family Planning Clinic, Behavioral Health Clinic, Rehabilitation Clinic, and Ambulatory Surgical Center fee schedules
Summary: Incorporates various 2020 Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, and Psychology fee schedules. In addition, there are updates to the reimbursement methodology for specified drugs in order to comply with the approved Medicaid State Plan methodology for physician-administered drugs
Summary: Incorporates the 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology and Independent Laboratory fee schedules
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new COVID-19 testing group and allowing for presumptive eligibility.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase payments to in-patient hospital rates.
Summary: Establishes a new minimum encounter rate for Federally Qualified Health Centers (FQHCs) based upon the national Medicare Prospective Payment System (PPS) base rate
