MedicaidReimbursementMedium impact
Payment Responsibility for Pain Management Clinic Toxicology Testing, Effective January 1, 2025
Maryland Medicaid·MD · Pain Management·Behavioral Health Administration Services Organization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has updated payment responsibility policies for toxicology testing performed at pain management clinics, effective January 1, 2025. This change affects how toxicology testing claims are processed and paid by Maryland Medicaid for pain management patients.
Action Required
Immediately: Billing team must review the full Maryland Medicaid transmittal PT 63-25 to understand new payment responsibility requirements for toxicology testing in pain management clinics. Update billing workflows and verify proper payer assignment for toxicology tests performed on Maryland Medicaid patients in pain management settings.