MedicaidReimbursementHigh impact
Evaluation and Management Rate Update FY 2025
Maryland Medicaid·MD·General Provider
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is reducing E&M reimbursement rates to 97.6% of Medicare effective September 1, 2024, through June 30, 2025. Additionally, a new add-on code G2211 for visit complexity is now billable to help offset reduced E&M payments for complex patient management.
Action Required
By September 1, 2024: Billing team must update Maryland Medicaid fee schedules in billing system to reflect 97.6% of Medicare E&M rates. Update all E&M billing rules and contracts. By January 1, 2024 (retroactive): Ensure billing system allows G2211 add-on code submission with qualifying E&M visits to capture additional reimbursement for complex cases. Providers should review current E&M visit documentation to identify retrospective claim opportunities for G2211 coding where complexity criteria were met. Contact mdh.professionalservicespolicy@maryland.gov with implementation questions. Failure to apply the new rates will result in overcharging Maryland Medicaid and subsequent claim denials or recoupment.