MedicaidAdministrativeMedium impact
Clarification on MCO Payment Responsibility for Health Behavior Assessments Administered in an Acute Care Setting
Maryland Medicaid·MD · Psychiatry, Emergency Medicine, Internal Medicine +1 more·Behavioral Health Administration Services Organization
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has clarified payment responsibility for health behavior assessments when administered in acute care settings. This update specifies which entity (MCO vs. hospital) is responsible for reimbursement of behavioral health assessments in hospital environments.
Action Required
Maryland providers: Review the full transmittal PT80-25 to understand MCO payment responsibilities for behavioral health assessments in acute care settings. Update billing workflows to ensure claims are submitted to the correct payer (MCO vs. hospital) based on the new clarification. Contact Maryland Medicaid if unclear about specific scenarios.