MedicaidAdministrativeHigh impact
Rescission of PT 21-22 Clarification of Payment Responsibility of Emergency Medicine Professional Fees in Emergency Department Settings
Maryland Medicaid·MD · Emergency Medicine·Provider Transmittal
Effective date
Dec 17, 2021
We identified it
Jun 20, 2026
Summary
The Maryland Department of Health is rescinding Hospital Transmittal No. 286/MCO Transmittal No. 147 (dated November 8, 2021), which provided clarification on payment responsibility for emergency medicine professional fees in ED settings. MDH will issue updated clarification after completing an internal review. Until new guidance is issued, the previous clarification is no longer in effect.
Action Required
Immediately: Billing team and providers must STOP following the payment responsibility guidance from PT 21-22 (Hospital Transmittal No. 286/MCO Transmittal No. 147). Do NOT bill emergency medicine professional fees using the previous clarification. Contact mdh.healthchoiceprovider@maryland.gov to request updated billing guidance from MDH. Monitor for PT 26-22 follow-up clarification document. Temporarily flag all emergency department professional fee claims for manual review until MDH issues new guidance to prevent claim denials or improper payments. This affects all emergency medicine billing to Maryland Medical Assistance Program (Medicaid managed care and traditional Medicaid).