MedicaidReimbursementHigh impact
Screening and Assessment Professional Rate Increase
Maryland Medicaid·MD · Pediatrics, Family Medicine, General Practice +1 more·General Provider
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program (Medicaid) is increasing reimbursement rates by 10% for screening and assessment services effective January 1, 2025. Billing teams must update their fee schedules for seven procedure codes (96110, 96127, 96161, W7000, W7010, W7020, W7021, W7022) to reflect new rates. Primary care physicians should ensure developmental and behavioral health screenings are billed during well-child visits per the Healthy Kids Preventive Health Schedule.
Action Required
By December 31, 2024: Billing team must update all fee schedules and billing system rates for Maryland Medicaid claims to reflect the new 10% increased rates for codes 96110, 96127, 96161, W7000, W7010, W7020, W7021, and W7022. Update all encounter forms, provider templates, and billing software to use the new rates listed in the policy. Providers should review the Maryland Healthy Kids Preventive Health Schedule (referenced in Provider Transmittal 50-25) to ensure developmental and behavioral health screenings are captured during well-child visits. Claims submitted on or after January 1, 2025 with old rates will result in underpayment.