MedicaidCoverageHigh impact
Payment of Medically Necessary Ancillaries on an Administrative Day
Maryland Medicaid·MD · Cardiology, Critical Care, Nephrology +3 more·Hospital
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program implemented a new policy allowing hospitals to bill select medically necessary ancillary services (labs, imaging, cardiology, renal, and respiratory services) on Administrative days when acute care is no longer required. Hospitals must submit requests via the updated MDH 1288 Form to the Utilization Control Agent (UCA) with documentation of placement activities, and only approved ancillaries from the specified list are eligible for reimbursement.
Action Required
By July 15, 2024: Billing team must obtain and review the updated MDH 1288 Form from the UCA Transition portal. Hospital administrative and billing staff must be trained on the new Administrative day ancillary billing process. Update internal billing procedures to identify eligible ancillary services from the approved list (labs, imaging, cardiology, renal, respiratory). When submitting retrospective reviews to the UCA, include the MDH 1288 form with ancillary service names clearly documented in the designated section. Claims submitted without proper UCA approval for ancillaries on Administrative days will be denied. Establish a process to track which ancillaries are approved per case to ensure accurate billing.