MedicaidAdministrativeHigh impact
Reinstating "128 - Beyond Statute"
Maryland Medicaid·MD · Geriatrics·Nursing Home
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is reinstating the '128 - Beyond Statute' denial code effective October 1, 2024. Providers can no longer submit electronically for claims receiving this denial code. Claims within 12 months of service may continue electronic submission, but claims beyond 12 months require paper submission to specific addresses with required cover letters explaining late submission reasons and supporting documentation.
Action Required
By October 1, 2024: Billing team must implement the following workflow changes: (1) Stop submitting electronically any claims that receive a '128 - Beyond Statute' denial code; (2) For Medicare claims within timely filing limits that receive this denial, submit paper claims to Maryland Department of Health, Medicaid Claims Processing Department, PO BOX 1935, Baltimore, MD 21203; (3) For non-Medicare and copay claims with Maryland Medicaid obligation beyond 12 months from date of service, submit paper claims to Maryland Department of Health, Provider Services - Institutional Provider Resolution, PO BOX 22751, Baltimore, MD 21203; (4) For all claims submitted beyond 12 months from date of service, attach a cover letter explaining the reason for late submission and include supporting documentation for the exception used; (5) Train staff to identify '128 - Beyond Statute' denials and route to appropriate paper submission process. Update billing system rules to flag this denial code and prevent electronic resubmission. Failure to follow these requirements will result in claim denials.