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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: To establish rates for outpatient services provided by public psychiatric hospitals and amend reimbursement methodology for public mental health clinics.
Summary: Amends attachment 4.19-B of the state plan to change the reimbursement methodology for electronconvulsive therapy (ECT) outpatient hospital services.
Summary: Updates the All Patient Refined Diagnosis Related Group software from version 31 to version 33 to coordinate with the federally required transition to International Classification of Diseases 10th Revision Code Sets.
Summary: Revises the DDS fee schedule consistent with Healthcare Common Procedures Coding System updates to ensure that this fee schedule remains compliant with the Health Insurance Portability and Accountability Act.
Summary: Adjusts reimbursement for dental services, including adding and deleting selected Current Dental Terminology codes to ensure the dental fee schedule remains compliant with the Health Issuance Portability and Accountability Act.
Summary: Revises the Dialysis Clinic fee schedule by adding HealthCare Common Procedure Coding System Code Q4801- Injection, epoetin, alfa, 100 Units for ESRD on dialysis to replace J0886.
Summary: Revises the reimbursement methodology for the following outpatient hospital services; removes center codes 403 and 320 and procedure codes 41899.
