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MedicaidBilling CodesMedium impact

PT 73-26: Update to Residential Habilitation Levels for Brain Injury Waiver

Maryland Medicaid·MD · PM&R (Physical Medicine & Rehab), Neurology·Medical Policy
Effective date
Sep 1, 2025
We identified it
Jun 18, 2026
Days to comply

Summary

Maryland's Brain Injury Waiver program added two new residential habilitation service levels (Level 4 and Level 5) with new billing codes W0040 and W0041, effective September 1, 2025. The updated fee schedule includes payment rates for all residential, day habilitation, supported employment, and individual support services.

Action Required

Action needed
Before September 1, 2025: Billing team must add new codes W0040 (Residential Habilitation Level 4 at $558.37/day) and W0041 (Residential Habilitation Level 5 at $775.80/day) to billing system for Maryland Brain Injury Waiver patients. Update all residential habilitation payment rates per the new fee schedule. Contact Jeronica Baldwin at jeronica.baldwin@maryland.gov or Elena Janetopoulos at elena.janetopoulos@maryland.gov with questions.

Affected Billing Codes

W0037
W0038
W0039
W0040
W0041
W0054
W0055
W0056
W0057
W0058
W0059
W0060
W0061