MedicaidBilling CodesMedium impact
Coverage of Community Violence Prevention Services Update
Maryland Medicaid·MD·Provider Transmittal
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program now allows Community Violence Prevention Providers designated at hospitals to bill CPT code 99402 for violence prevention services, with a limit of 8 units per day per participant and a maximum of 100 units per 12-month rolling period. This update clarifies billing procedures for community violence prevention services effective July 1, 2023.
Action Required
By July 1, 2023: Billing team must ensure that providers with Violence Prevention (VP) Provider Type designation are configured in the billing system to bill CPT 99402 for community violence prevention services. Implement unit-of-service limits in billing software: maximum 8 units per day, per participant, and maximum 100 units per participant on a 12-month rolling basis. Update billing validation rules to enforce these limits and prevent overbilling. Communicate updated billing procedures to all providers rendering these services at the hospital. Verify provider enrollment status with mdh.providerenrollment@maryland.gov for those unclear about VP Provider Type designation. Claims submitted without proper VP Provider Type designation or exceeding the unit limits will be subject to denial.