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Winter General Provider Updates

Maryland Medicaid·MD·Provider Transmittal
Effective date
Jan 3, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid implements multiple policy changes including Carr v. Becerra reimbursements for dual beneficiaries, pharmacy claim denials for unenrolled prescribers starting January 3, 2024, expanded gender-affirming treatment coverage, and unique NPI requirements for facilities by February 1, 2024.

Action Required

Action needed
By January 3, 2024: Verify all prescribers are enrolled in Maryland Medicaid to prevent pharmacy claim denials for non-behavioral health drugs. By February 1, 2024: Ensure each facility location has a unique NPI for billing. Process any Carr v. Becerra reimbursement requests by completing attestation forms and submitting paper claims. Update billing systems to accommodate new gender-affirming treatment codes (see PT 36-24). Claims will be denied if prescribers are not enrolled or if shared NPIs are used after deadlines.
Winter General Provider Updates | Maryland Medicaid | PolicyChanges.app