Overview

Current State Plan Amendments submitted to the Centers for Medicare & Medicaid Services (CMS) within the U.S. Department of Health and Human Services (HHS).     

25-A: January 2025 Quarterly HIPAA Compliant Update - Physician Office and Outpatient Fee Schedule, Physician Surgery, Physician Radiology, Independent Radiology, Laboratory Services, and DMEPOS Fee Schedules/ Updates to the Autism Services, Adult Dental Services and PCMH+ Services” – posted December 24, 2024.

SPA 25-B: Clinic Services – 1.) January 2025 HIPAA Compliant Updates for Dialysis Clinics, Family Planning Clinics, Medical Clinics, and Behavioral Health Clinic Fee Schedules 2.) Updates to Physician Administered Drugs for Behavioral Health Clinics, Dialysis Clinics, Family Planning Clinics, and Medical Clinics) - posted December 23, 2024.

SPA 25-C: New Medicaid Coverage of Services Provided by Certified Doulas – posted October 22, 2024.

SPA 25-D Pharmacy Value Based Purchasing (VBP) Supplemental Rebate Agreement” - posted December 24, 2024.

SPA 25-F: Pediatric Inpatient Psychiatric Services: Interim Rate-Add-Ons and Change to Medically Necessary Discharge Delay Reimbursement Methodology - posted December 20, 2024.

SPA 25-G: Consolidated Appropriations Act of 2023 – posted December 24, 2024.

SPA 25-H: Community First Choice - Reimbursement Updates to Implement Personal Care Attendant Collective Bargaining Agreement - posted December 17, 2024

SPA 25-L: Supplemental Payment for Obstetrical Services Program – Restructuring Scoring for Quality Performance Measures - posted December 26, 2024.

SPA 25-O: SPA: Increase to the Reimbursement Rate to Select Long-Acting Reversible Contraceptive Device- posted December 26, 2024.

SPA 25-P: Addition of Coverage for Electronic Consultations (E-Consults) - posted December 26, 2024.

SPA 25-T: April 2025 Quarterly HIPAA Compliant Updates – Physician Office and Outpatient Fee [Schedule and DMEPOS Fee Schedule] - posted March 25, 2025

SPA 25-0011: Chronic Disease Hospital Reimbursement – posted February 24, 2025.

SPA 25-0014 Pharmacy Obesity Weight Loss Drug Coverage - posted February 25, 2025.

Note: Website notices will be archived every quarter of the year. All notices are placed in the corresponding archive folder determined by the posting date.