MedicaidCoverageMedium impact
Medicaid Coverage for Radiological and Imaging Services Provided by Certified Nurse Practitioners
Maryland Medicaid·MD · Radiology, OB-GYN, Radiation Oncology·Managed Care Organizations
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Effective July 1, 2025, Maryland Medicaid now reimburses Certified Nurse Practitioners (CRNPs) for interpretation of specific radiological and imaging services. Billing teams must update systems to recognize CRNPs as eligible providers for 13 allowable CPT codes across chest X-rays, abdominal X-rays, obstetric ultrasounds, and radiotherapy planning. This applies to both fee-for-service and HealthChoice managed care organizations in Maryland.
Action Required
Before July 1, 2025: Billing team must update claims processing system and billing software to permit CRNPs as valid interpreting providers for CPT codes 71045, 71046, 74018, 74019, 76801, 76802, 76815, 76817, 76819, 76830, 76882, 76937, and 77301 within Maryland Medicaid (fee-for-service and HealthChoice MCOs). Verify that CRNP credentials and active enrollment status are confirmed in claims before submission. Update provider credentialing records to flag eligible CRNPs. Do not submit these codes billed by CRNPs before July 1, 2025, as they will be denied. Contact mdh.professionalservicespolicy@maryland.gov (FFS) or mdh.healthchoiceprovider@maryland.gov (HealthChoice) for enrollment verification questions.