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MedicaidReimbursementMedium impact

Coverage of CenteringPregnancy and HealthySteps Services

Maryland Medicaid·MD · OB-GYN, Pediatrics, Family Medicine·Provider Transmittal
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid will provide additional reimbursement for CenteringPregnancy and HealthySteps services starting January 1, 2023. Eligible practices can bill CPT 99078 for an additional $50 per CenteringPregnancy visit and HCPCS H0025 for an additional $15 per HealthySteps visit, but must first obtain proper accreditation and submit supplemental applications in ePREP.

Action Required

Action needed
For practices interested in these programs: 1) Obtain accreditation from Centering Healthcare Institute (for CenteringPregnancy) or ZERO TO THREE (for HealthySteps), 2) Submit supplemental applications in ePREP with accreditation letters and required addendums for both the group practice and each rendering provider, 3) Update billing system to add CPT 99078 (CenteringPregnancy - $50 additional per visit, up to 10 visits) and HCPCS H0025 (HealthySteps - $15 additional per visit up to age 4, billed with pediatric E&M visits, do not bill to ASO).

Affected Billing Codes

99078
H0025