Fee Schedules 

Reimbursement in the Public Behavioral Health System (PBHS):

A fee schedule is a complete listing of service codes and fees used to pay services within the PBHS system. Optum Maryland has provided a listing of Mental Health, Substance Use Disorder and other specific levels of care by fee schedules for Providers to use.

The ABA Fee Schedule can be viewed on the Autism Providers Information page, here

• PBHS Provider Billing Appendix.pdf

State Fiscal Year 2021 (Effective January 1, 2021)

• PMHS PRP Billing Cascade (Eff -01-01-21)
• PMHS Individual Practitioner and OMHC  Rates (Eff -01-01-21)
• PMHS PRP and Specialty Programs Rates (Eff-01-01-21)
• PMHS 1915(i) Fee Schedule (Eff-01-01-21)
• PBHS SUD Fee Schedule (Eff-01-01-21)
• PBHS Gambling Fee Schedule (Eff-01-01-21)
• PBHS SUD-Gambling Fee Schedule (Eff-01-01-21)
• PBHS SUD Gambling Residential (Eff-01-01-21)

State Fiscal Year 2021 (Effective July 1, 2020)

• PMHS PRP Billing Cascade (Eff -07-01-20)
• PMHS Individual Practitioner and OMHC  Rates (Eff -07-01-20)
• PMHS PRP and Specialty Programs Rates (Eff-07-01-20)
• PMHS 1915(i) Fee Schedule (Eff-07-01-20)
• PBHS SUD Fee Schedule (Eff-07-01-20)
• PBHS Gambling Fee Schedule (Eff-07-01-20)
• PBHS SUD-Gambling Fee Schedule (Eff-07-01-20)
• PBHS SUD Gambling Residential (Eff-07-01-20)

State Fiscal Year 2020 (Effective July 1, 2019 - June 30, 2020)

• PMHS PRP Billing Cascade (Eff-07.01.19 - 06.30.20).pdf
• PMHS Individual Practitioner and OMHC Rates (Eff-07.01.19 - 06.30.20).pdf
• PMHS PRP and Specialty Programs Rates (Eff-07.01.19 - 06.30.20).pdf
• PMHS 1915i Fee Schedule (Eff-07.01.19 - 06.30.20).pdf
• SUD Fee Schedule (Eff-07.01.19 - 06.30.20).pdf
• SUD Fee Schedule (Eff-01.01.20 - 07.30.20)
• 8-507/PWC Grant Program Fee Schedule (Eff. 07-01-19).pdf
• Health Homes Fee Schedule (Eff -07-01-19).pdf 

The combination of services rules provide an outline of the types of services that may be provided to an individual within the same day, week or course of treatment. These rules outline the interventions that may be implemented in combination and involve the use of two or more coordinated interventions by the same or differing providers.

• Combination of SUD Services (Eff-07-1-17).pdf
• Combination of MH Services.pdf

State Fiscal Year 2019

• 1915i Fee Schedule (Eff-07-01-18).pdf
• PBHS Reimbursement Schedule A (Eff-07-01-18 Rev-03-14-19).pdf
• PBHS Reimbursement Schedule B (Eff-07-01-18 Rev-03-14-19).pdf

Prior State Fiscal Years

• 8-507/PWC Grant Program Fee Schedule (Eff. 1-1-18).pdf
• FQHC Fee Schedule 07-01-17 (pdf)
• Maryland Recovery Network (MDRN) Fee Schedule 09-30-16.pdf
• SUD Matrix (Eff-05-15-17) pdf
• Grant based Fee Schedule.pdf

Gambling Information