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Maryland MedicaidMedicaid · Coverage · Provider Transmittal · MD · Psychiatry, Family Medicine, Internal MedicineMedium impact

Coverage of Buprenorphine Injection –REVISED May 13, 2020

Act
by Jun 30, 2020 (retroactive to Jul 1, 2019)
Effective date
Jul 1, 2019
Identified
Jun 20, 2026

Summary

Maryland Medicaid (MMCP) now covers buprenorphine extended-release injection (Sublocade®) for opioid use disorder treatment when medically necessary, effective July 1, 2019. Data 2000 waived practitioners can bill using HCPCS codes Q9991 and Q9992 with updated reimbursement rates effective January 1, 2020. This is a revised transmittal clarifying coverage and billing procedures for substance use disorder treatment.

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What to do

by Jun 30, 2020 (retroactive to Jul 1, 2019) · 6 steps
01Billing team must update billing system to recognize and process HCPCS codes Q9991 and Q9992 for Maryland Medicaid claims.
02Update fee schedules to reflect current rates (Q9991 and Q9992 both at $1,673.36 effective 1/1/2020).
03Ensure claims are submitted through Incedo Provider Portal, EDI 837 batch files, or U.S. Mail per Maryland PBHS Provider Billing Appendix.
04For dates of service on or after July 1, 2019, verify medical necessity documentation per MMCP Clinical Criteria before billing.
05Train providers and billing staff that these codes are only billable by Data 2000 waived practitioners.
06For preauthorization and billing questions, direct to Optum Maryland at marylandproviderrelations@optum.com or 1-800-888-1965.

Codes mentioned

Q9991Q9992

Original notice

Coverage of Buprenorphine Injection –REVISED May 13, 2020
health.maryland.gov no longer serves this document. We saved a copy on Nov 6, 2026.
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Related changes

See all Maryland Medicaid changes →
Updates to Reimbursement Rates and Coverage for Long-Acting Injectable Buprenorphine for Substance Use DisordersHighEffective Mar 1, 2026 · Behavioral Health Administration Services OrganizationPT 75-26: Updates to Reimbursement Rates and Coverage for Long-Acting Injectable Buprenorphine for Substance Use DisordersMediumEffective Mar 1, 2026 · Claims & BillingCoverage of Buprenorphine InjectionMediumNo effective date · Provider TransmittalBrowse every Maryland Medicaid change in the policy list

Related policy hubs

Maryland Medicaid policiesMD policy changesPsychiatryFamily MedicineInternal MedicineCode Q9991Code Q9992

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