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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 11 - 20 of 15934

Nevada

This plan amendment updates the Disproportionate Share Hospital payment time period to the current fiscal year, the fiscal year amount, and the payment frequency.

Approval Date: September 4, 2025
Effective Date: July 1, 2025

Iowa

This plan amendment will increase rates for an acuity add-on for each service date for individuals that meet the medical necessity of various levels.

Approval Date: September 4, 2025
Effective Date: July 1, 2025

Georgia

This plan amendment updates the rates for two primary care codes (99213 and 99214) to 2.154%.

Approval Date: September 4, 2025
Effective Date: July 1, 2025

South Carolina

This plan amendment updates the Supplemental Teaching Physician (STP) Payment Program.

Approval Date: September 4, 2025
Effective Date: April 1, 2025

Georgia

This plan amendment updates the rate for Select Dental codes to 2.5%.

Approval Date: September 4, 2025
Effective Date: July 1, 2025

Georgia

This plan amendment updates the Emergency Air Ambulance services.

Approval Date: September 4, 2025
Effective Date: July 1, 2025

Florida

This amendment updates Florida’s personal care benefit for home health agencies and terminology for excluding care provided by legally responsible adults for beneficiaries under 21 years of age.

Approval Date: September 4, 2025
Effective Date: December 1, 2024
Topics: Benefits Coverage Home Health Prior Authorization

Delaware

This SPA updates the payment methodology for physician administered drugs and high investment medications.

Approval Date: September 3, 2025
Effective Date: July 1, 2025

South Dakota

This amendment covers peer support services and a rate increase for Community Mental Health Centers and Substance Use Disorder Agency services.

Approval Date: September 3, 2025
Effective Date: June 1, 2025

Delaware

This amendment proposes to provide additional postpartum visits with a recommendation by a practitioner or clinician licensed under Title 24 acting within their scope of practice.

Approval Date: September 3, 2025
Effective Date: April 2, 2025
Topics: Benefits Coverage and Reimbursement Preventive Services