U.S. flag

An official website of the United States government

Medicaid State Plan Amendments

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.

Results

Displaying 1 - 10 of 15880

Kentucky

This plan amendment is amending its State Plan to implement a quality program funded by the provider assessment and clarifying how payment for ancillary services is part of the per diem rate.

Approval Date: August 21, 2025
Effective Date: July 1, 2025

Missouri

The purpose of this plan amendment is to add a Prospective Payment System (PPS) and an Alternative Payment Method for Provider Based Rural Health Clinics (PBRHCs).

Approval Date: August 21, 2025
Effective Date: January 1, 2025

Maine

This plan amendment updates the total inpatient pool amounts for the Total Critical Access Hospital (CAH) Supplemental Pool and the Total Acute Care Hospital (ACH) Supplemental Pool.

Approval Date: August 21, 2025
Effective Date: November 15, 2024

Puerto Rico

This amendment was submitted to update section 7.2 Nondiscrimination and 7.4 State Governor’s review pages.

Approval Date: August 20, 2025
Effective Date: July 1, 2025

Massachusetts

This plan amendment updates base per diem rates, makes provisions for new and existing supplemental payments. It also makes technical edits to existing supplemental payments.

Approval Date: August 18, 2025
Effective Date: October 1, 2024

Massachusetts

This plan amendment makes changes to reimbursement for nursing facility services. Changes include updates to specified cost adjustment factors and establishment of new add-on and supplemental payments.

Approval Date: August 18, 2025
Effective Date: October 1, 2024

Washington

The purpose of this SPA was to update the effective date of the fee schedules for several Medicaid services.

Approval Date: August 18, 2025
Effective Date: April 1, 2025

Texas

This plan amendment updates the payment rate and rate methodology for the Pediatric Care Facility Special Reimbursement Class of Nursing Facilities.

Approval Date: August 18, 2025
Effective Date: April 1, 2025

Texas

This plan amendment updates the physicians’ and other practitioners’ program fee schedules.

Approval Date: August 18, 2025
Effective Date: April 1, 2025

Massachusetts

This plan amendment updates reimbursement for inpatient psychiatric and substance abuse treatment hospital services for rate year 2025.

Approval Date: August 18, 2025
Effective Date: October 1, 2024