MedicaidCoverageMedium impact
Orthoses and Prostheses Coverage Expansion under the "So Every Body Can Move Act", Effective January 1, 2025
Maryland Medicaid·MD · Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy +2 more·DME/DMS
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has expanded coverage for orthoses and prostheses under the 'So Every Body Can Move Act' effective January 1, 2025. This expansion likely increases covered DME items and may change prior authorization or documentation requirements for orthotic and prosthetic devices.
Action Required
By January 1, 2025: Billing team should review the full Maryland Medicaid transmittal PT 55-25 to identify newly covered orthoses and prostheses items. Update billing system with any new covered HCPCS codes and revised prior authorization requirements. Verify eligibility for Maryland Medicaid patients needing orthotic or prosthetic devices.