MedicaidCoverageMedium impact
Waived Four Walls Requirement - Outpatient Mental Health Clinics
Maryland Medicaid·MD · Psychiatry·Behavioral Health Administration Services Organization
Effective date
Jun 1, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has waived the Four Walls requirement for Outpatient Mental Health Clinics, allowing them to bill at clinic rates for telehealth services when both provider and patient are offsite. This supersedes previous guidance from July 2024 and is effective June 1, 2025.
Action Required
Effective June 1, 2025: Maryland OMHCs billing team must update telehealth billing procedures to allow clinic rate billing for services when both practitioner and patient are offsite. Update billing system settings to accept these telehealth claims at clinic rates rather than lower telehealth rates for Maryland Medicaid patients.