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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.

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Showing 1 to 10 of 90 results
Transmittal Number: TX-21-0049
State: Texas
Summary: Attest that certain specific minimum requirements are met by drivers and providers of non-emergency medical transportation services.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: TX-21-0046
State: Texas
Summary: Ensures that the Texas Medicaid State Plan complies with the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019, affecting the BBA of 2013, that modified third party

liability (TPL) requirements related to special treatment of certain types of care and payment.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: TX-21-0002
State: Texas
Summary: Clarifies that, to the extent required by EPSDT, a licensed behavior analyst (LBA) operating within the LBA’s state scope of practice and licensure requirements may provide applied behavior analysis (ABA) evaluation and treatment services to children under 21 who have a diagnosis of autism spectrum disorder (ASD).
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Benefits
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Transmittal Number: TX-21-0041
State: Texas
Summary: Updates the physicians' and other practitioners' fee schedules.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: TX-21-0011
State: Texas
Summary: Expands the community based provider agency options for Medicaid recipients who have been found through the PASRR process to need specialized add-on services. Additionally, amendments were made to behavioral support and day habilitation services descriptions to be consistent with state administrative rule language and updates language about settling locations.
Approval Date:
Effective Date:
Topics:
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Transmittal Number: TX-20-0019
State: Texas
Summary: Effective September 1, 2020, this amendment updates the physicians' and other practitioners' fee schedules. 
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: TX-20-0018
State: Texas
Summary: Effective July 1, 2020, this amendment implements a reimbursement methodology for when a new national procedure code is assigned for HealthCare Common Procedure Coding System (HCPCS) updates and when federally-mandated reimbursement rates, physician-administered drugs (PADs), or biological products are released. 
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Financing & Reimbursement
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Transmittal Number: TX-20-0014
State: Texas
Summary: updates the durable medical equipment, prosthetics, orthotics, supplies (DMEPOS) and vision care services fee schedules
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: AS-20-0001
State: American Samoa
Summary: Effective October 1, 2020, this amendment adds a new benefit of Personal Care Services and payment methodology for the service.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
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Transmittal Number: TX-20-0017
State: Texas
Summary: the family planning fee schedule
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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