MedicaidBilling CodesHigh impact
Billing for Developmental Screenings Performed During Well-Child Visits
Maryland Medicaid·MD · Pediatrics, Family Medicine, General Practice·EPSDT
Effective date
Dec 3, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program (Medicaid) now explicitly authorizes primary care physicians to bill CPT code 96110 for developmental and behavioral health screenings performed during well-child visits under the EPSDT benefit. The fee-for-service reimbursement rate is $8.86. This clarification ensures PCPs can capture billable screening services that align with the Maryland Healthy Kids Preventive Health Schedule.
Action Required
Effective immediately (December 3, 2024): Billing team must update billing system and encounter forms to enable providers to bill CPT 96110 for developmental and behavioral health screenings administered during well-child visits in Maryland Medicaid (EPSDT) patients. Ensure CPT 96110 is mapped to the correct reimbursement rate of $8.86 in the fee schedule. Train providers and front-desk staff that these screenings are now billable during well-child visits per the Maryland Healthy Kids Preventive Health Schedule. Audit recent well-child visit claims to identify missed billing opportunities and resubmit claims with CPT 96110 where applicable.