Amendment to TCM/Coordination of Community Services reimbursement rates and funding
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Amendment to the Maryland Medicaid State Plan establishing rates and a 2% funding reduction for Targeted Case Management (TCM)/Coordination of Community Services (CCS) effective July 1, 2026; affects CCS/TCM providers serving Medicaid participants in Maryland.
Maryland's Fiscal Year 2027 budget reduces the funding percentage paid to Coordination of Community Services agencies for services by 2%.
New published rates effective July 1, 2026: Comprehensive Assessment $441.00 per assessment; Community Coordination/Waiting List Coordination/Transition Coordination $27.76 per 15-minute unit.
A geographic differential rate of $29.76 per 15-minute unit applies for Coordination services provided to participants residing in specified higher cost counties.
Coverage Criteria for Targeted Case Management / Coordination of Community Services
Payment criteria
Effective July 1, 2026, the following payment criteria apply for TCM/CCS services:
ALL of the following
ALL of the following
- The rate for the Comprehensive Assessment will be $441.00 per assessment.
ALL of the following
- The rate for Community Coordination, Waiting List Coordination, and Transition Coordination will be $27.76 per 15-minute unit.
ALL of the following
- A geographic differential rate of $29.76 per 15-minute unit applies to Coordination services provided to participants residing in designated higher cost Maryland counties (Calvert, Charles, Frederick, Montgomery, Prince George's).
Applies only to Coordination services and only for participants residing in the listed counties.
ALL of the following
- Maryland's Fiscal Year 2027 budget reduces the funding percentage paid to Coordination of Community Services agencies for services by 2% (estimated total fund decrease $2,866,030.00).
ALL of the following
- Calvert County
- Charles County
- Frederick County
- Montgomery County
- Prince George's County
ALL of the following
- All Medicaid state plan services must be approved by the Centers for Medicare & Medicaid Services (CMS).
Rates, Units, and Geographic Differential
| Comprehensive Assessment | $441.00 per assessment |
| Community Coordination / Waiting List Coordination / Transition Coordination | $27.76 per 15-minute unit |
| Coordination services (geographic differential) | $29.76 per 15-minute unit (applies only for participants residing in designated higher cost counties: Calvert, Charles, Frederick, Montgomery, Prince George's) |
Provider Actions and Payment Rate Updates
Payment rates published — update billing to new rates (effective 7/1/2026)
No prior authorization or documentation changes are specified in this notice. The notice only publishes new reimbursement amounts and a geographic differential, effective July 1, 2026; providers should update billing systems and claim lines to reflect the new per-assessment and per-15-minute unit rates and apply the geographic differential where applicable.
- Effective 7/1/2026: Comprehensive Assessment = $441.00 per assessment.
- Effective 7/1/2026: Community Coordination / Waiting List Coordination / Transition Coordination = $27.76 per 15-minute unit.
- Geographic differential = $29.76 per 15-minute unit for services to participants residing in Calvert, Charles, Frederick, Montgomery, and Prince George's counties.
- No change to prior authorization or documentation requirements is specified in this notice.
Key Definitions
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