MedicaidCoverageMedium impact
Clarification on HealthChoice Coverage for Special Pediatric Hospitals
Maryland Medicaid·MD · Pediatrics·Provider Transmittal
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has issued clarification on HealthChoice coverage for special pediatric hospitals. This policy update provides guidance on how HealthChoice managed care plans should handle coverage and billing for services provided at specialized pediatric facilities.
Action Required
Immediately: Billing teams at pediatric practices and special pediatric hospitals in Maryland should review the full transmittal document to understand updated HealthChoice coverage requirements. Verify current billing procedures align with clarified guidelines and update prior authorization workflows if necessary. Contact HealthChoice plans to confirm any changes in coverage verification processes.