MedicaidReimbursementMedium impact
Mass Adjustments for Professional Services Claims
Maryland Medicaid·MD · Podiatry, Ophthalmology, Physical Therapy +2 more·Provider Transmittal
Effective date
Mar 10, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medicaid automatically adjusted professional services claims billed between January 1 - March 10, 2021 to reflect updated 2021 fee schedule rates (effective after CMS released updated Medicare rates in December 2020). Providers may submit manual adjustment requests for claims billed below the current allowed amount. Mass adjustments occurred the week of June 14, 2021.
Action Required
By June 14, 2021: Billing team should monitor remittance advice for automatic claim adjustments reflecting updated 2021 Professional Services Fee Schedule rates. For any claims billed at rates lower than current allowed amounts between January 1 - March 10, 2021, submit manual adjustment requests using Form 4518A or 4567 to: Maryland Medical Assistance Adjustment Unit, P.O. Box 13045, Baltimore, MD 21203, or call (410) 767-5346. Obtain the 2021 Professional Services Fee Schedule and adjustment forms from health.maryland.gov/providerinfo under Billing Guidance section. For fee schedule questions, email mdh.professionalservicespolicy@maryland.gov. Note: This is a historical policy (June 2021); verify if retroactive adjustments have already been processed.