MedicaidCoverageMedium impact
Continued Medicaid Coverage of COVID-19 Vaccines for Adults
Maryland Medicaid·MD · Allergy & Immunology, Family Medicine, Internal Medicine +3 more·General Provider
Effective date
Sep 19, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid continues to cover COVID-19 vaccines for all adults aged 19 and older as medically necessary services, regardless of underlying medical conditions. This policy aligns with updated FDA and ACIP recommendations that shifted from universal vaccination to shared decision-making for COVID-19 immunization. Both Fee-For-Service and HealthChoice MCOs must reimburse in-network providers for medically necessary COVID-19 vaccines administered within scope of practice.
Action Required
By September 19, 2025: Billing and clinical staff must ensure COVID-19 vaccine claims are processed as covered medically necessary services for all Maryland Medicaid members aged 19 and older, without requiring medical condition documentation. Providers should document shared decision-making conversations with patients per MDH Standing Order 2025-2026 COVID Vaccine guidance. Contact mdh.healthchoiceprovider@maryland.gov if claims are denied or if there are access concerns. Update internal billing policies to reflect that COVID-19 vaccines remain covered under Maryland Medicaid despite the change in ACIP recommendations.