MedicaidCoverageMedium impact
Maryland Medicaid Reimbursement for Medication Therapy Management Services
Maryland Medicaid·MD · Pharmacy·Provider Transmittal
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now covers Medication Therapy Management (MTM) services provided by pharmacists for eligible Fee-for-Service participants starting January 1, 2024. New CPT codes 99605, 99606, and 99607 are available for billing MTM encounters with specific eligibility criteria and coverage limitations.
Action Required
By January 1, 2024: Billing teams in Maryland must add CPT codes 99605, 99606, and 99607 to billing systems for MTM services. Update systems to enforce limitations: one unit per patient per 365 days for 99605/99606, two units per 365 days for 99607, max one unit per day. Note that MTM requires participant referral by the Program and excludes Medicare Part D eligible patients.