MedicaidCoverageMedium impact
Reimnursement for Remote Patient Monitoring Services Provided Through Physicians, Nurse Practitioners, and Physician Assistants Effective January 1, 2018
Maryland Medicaid·MD · Family Medicine, Internal Medicine, Cardiology +2 more·Provider Transmittal
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now reimburses Remote Patient Monitoring (RPM) services using HCPCS code S9110 at $125 per 30-day period for qualified participants with COPD, congestive heart failure, or diabetes who meet specific hospitalization criteria. Preauthorization is required for all RPM episodes.
Action Required
Immediately: Billing team must obtain preauthorization by faxing requests to Monasha Holloway at 410-333-5050 before providing RPM services. Bill using HCPCS code S9110 for qualified Medicaid participants with COPD, congestive heart failure, or diabetes. Update billing system to track 60-day episodes and ensure no more than two episodes per participant in a 12-month rolling period. Verify participant meets hospitalization/ED visit criteria before starting services.