MedicaidReimbursementHigh impact
Updated Individual and Group Mental Health Practitioner Fee Schedule, Effective January 1, 2025
Maryland Medicaid·MD · Psychiatry·Behavioral Health Administration Services Organization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is updating reimbursement rates and coding for individual psychotherapy services effective January 1, 2025. Providers must now bill CPT 90837 for 60-minute individual psychotherapy sessions and CPT 90838 as an add-on code, with rates varying by provider licensure type (ranging from $101.07 to $141.31 per code).
Action Required
By December 31, 2024: Billing team must update all billing software and encounter templates to reflect new CPT codes 90837 and 90838 for 60-minute individual psychotherapy sessions. Verify provider licensure classifications in the system match the fee schedule table (Psychiatrist, CRNP-PMH, APRN-PMH, Psychologist, LCSW-C, LCPC, LMFT, LCPAT, or LCADC) to ensure correct rate assignment. Update any standing orders or templates currently using different psychotherapy codes. Configure system to apply the correct reimbursement rate based on each provider's licensure type. Communicate changes to all providers and front-desk staff. Failure to implement by January 1, 2025 will result in claim denials or incorrect reimbursement amounts.