Copayment Level | Region U | Region V | Region W | Region X | Region Y | Region Z | Region BC |
A | $4.56 | $4.03 | $5.60 | $7.22 | $5.54 | $4.12 | $5.15 |
B | 7.29 | 6.45 | 8.95 | 11.55 | 8.77 | 6.59 | 8.24 |
C | 11.85 | 10.49 | 14.55 | 18.77 | 14.31 | 10.71 | 13.40 |
D | 17.32 | 15.33 | 21.26 | 27.44 | 21.00 | 15.65 | 19.58 |
E | 22.79 | 20.17 | 27.98 | 36.10 | 27.69 | 20.59 | 25.76 |
F | 29.18 | 25.82 | 35.81 | 46.21 | 35.31 | 26.36 | 32.98 |
G | 35.56 | 31.47 | 43.64 | 56.32 | 43.15 | 32.12 | 40.19 |
H | 41.03 | 36.31 | 50.36 | 64.99 | 49.85 | 37.06 | 46.37 |
I | 43.77 | 38.73 | 53.54 | 69.32 | 53.08 | 39.54 | 49.46 |
J | 45.59 | 40.34 | 55.61 | 72.21 | 55.38 | 41.18 | 51.52 |
Copayment Level | Region U | Region V | Region W | Region X | Region Y | Region Z | Region BC |
A | $2.74 | $2.42 | $3.36 | $4.33 | $3.23 | $2.47 | $3.09 |
B | 5.47 | 4.84 | 6.71 | 8.66 | 6.69 | 4.94 | 6.18 |
C | 9.12 | 8.07 | 11.19 | 14.44 | 11.08 | 8.24 | 10.30 |
D | 12.76 | 11.30 | 15.67 | 20.22 | 15.46 | 11.53 | 14.43 |
E | 18.24 | 16.14 | 22.38 | 28.88 | 22.15 | 16.47 | 20.61 |
F | 22.79 | 20.17 | 27.98 | 36.10 | 27.69 | 20.59 | 25.79 |
G | 28.27 | 25.01 | 34.69 | 44.77 | 34.15 | 25.53 | 31.94 |
H | 31.91 | 28.24 | 39.17 | 50.54 | 38.77 | 28.83 | 36.07 |
I | 34.65 | 30.66 | 42.52 | 54.88 | 42.00 | 31.30 | 39.16 |
J | 36.47 | 32.27 | 44.76 | 57.76 | 44.31 | 32.95 | 41.22 |
Copayment Level | Region U | Region V | Region W | Region X | Region Y | Region Z | Region BC |
A | $5.82 | $4.88 | $7.62 | $9.05 | $7.17 | $4.53 | $6.84 |
B | 9.31 | 7.81 | 12.20 | 14.48 | 11.47 | 7.25 | 10.95 |
C | 15.13 | 12.70 | 19.82 | 23.53 | 18.63 | 11.79 | 17.80 |
D | 22.12 | 18.56 | 28.97 | 34.39 | 27.23 | 17.23 | 26.01 |
E | 29.10 | 24.42 | 38.12 | 45.25 | 35.83 | 22.67 | 33.69 |
F | 37.25 | 31.25 | 48.79 | 57.92 | 45.86 | 29.01 | 42.46 |
G | 45.40 | 38.09 | 59.46 | 70.59 | 55.89 | 35.36 | 51.46 |
H | 52.38 | 43.95 | 68.61 | 81.45 | 64.49 | 40.80 | 59.08 |
I | 55.87 | 46.88 | 73.18 | 86.88 | 68.79 | 43.52 | 62.77 |
J | 58.20 | 48.83 | 76.23 | 90.46 | 71.66 | 45.34 | 65.31 |
Copayment Level | Region U | Region V | Region W | Region X | Region Y | Region Z | Region BC |
A | $3.49 | $2.93 | $4.57 | $5.43 | $4.30 | $2.72 | $4.11 |
B | 6.98 | 5.86 | 9.15 | 10.86 | 8.60 | 5.44 | 8.21 |
C | 11.64 | 9.77 | 15.25 | 18.10 | 14.33 | 9.07 | 13.69 |
D | 16.30 | 13.67 | 21.35 | 25.34 | 20.06 | 12.69 | 19.17 |
E | 23.28 | 19.53 | 30.49 | 36.20 | 28.66 | 18.13 | 27.38 |
F | 29.10 | 24.42 | 38.12 | 25.25 | 35.83 | 22.67 | 33.69 |
G | 36.09 | 30.28 | 47.26 | 56.11 | 44.43 | 28.11 | 41.31 |
H | 40.74 | 34.18 | 53.36 | 63.35 | 50.16 | 31.73 | 46.38 |
I | 44.23 | 37.11 | 57.94 | 68.78 | 54.46 | 34.46 | 50.08 |
J | 46.56 | 39.07 | 60.99 | 72.40 | 57.33 | 36.27 | 52.62 |
Copayment Level | Copayment Percentage |
A | 5% |
B | 8% |
C | 13% |
D | 19% |
E | 25% |
F | 32% |
G | 39% |
H | 45% |
I | 48% |
J | 50% |
Copayment Level | Copayment Percentage |
A | 3% |
B | 6% |
C | 10% |
D | 14% |
E | 20% |
F | 25% |
G | 31% |
H | 35% |
I | 38% |
J | 40% |
Md. Code Regs. 13A.14.06.12
Regulation .12A amended effective June 16, 1978 (5:12 Md. R. 966); December 28, 1979 (6:26 Md. R. 2072); September 5, 1980 (7:18 Md. R. 1739); February 6, 1981 (8:3 Md. R. 225); October 26, 1981 (8:21 Md. R. 1705); December 6, 1982 (9:24 Md. R. 2388)
Regulation .12A, D amended effective September 14, 1981 (8:18 Md. R. 1477)
Regulation .12C, D amended effective June 26, 1981 (8:13 Md. R. 1137)
Regulations .12 adopted effective October 1, 1996 (23:19 Md. R. 1374)
Regulations .12 amended as an emergency provision effective August 1, 1997 (24:16 Md. R. 1140)
Regulations .12 amended as an emergency provision effective October 6, 1997 (24:21 Md. R. 1443); amended permanently effective December 29, 1997 (24:26 Md. R. 1755)
Regulation .12 amended effective January 1, 1997 (23:26 Md. R. 1858)
Regulations .12 amended effective May 1, 2000 (27:8 Md. R. 797)
Regulation .12 amended effective January 1, 2002 (28:24 Md. R. 2127)
Regulation .12B, C amended effective February 1, 2004 (31:1 Md. R. 30)
Regulation .12B amended as an emergency provision effective October 15, 2007 (34:23 Md. R. 2019)
Regulation .12 amended effective March 24, 2008 (35:6 Md. R. 699)
Regulations .12 adopted effective January 4, 2010 (36:26 Md. R. 1996)
Regulation .12 repealed and new Regulation .12 adopted effective November 29, 2010 (37:24 Md. R. 1659)
Regulation .12 amended and recodified from Regulation .10 effective 42:6 Md. R. 512, eff.3/30/2015