MedicaidCoverageMedium impact
Gender Transition: Covered Service, Coverage Criteria, Limitations and Exclusions
Maryland Medicaid·MD · Plastic Surgery, Endocrinology, Psychiatry +3 more·Provider Transmittal
Effective date
Dec 10, 2015
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now covers comprehensive gender transition services including psychotherapy, hormone therapy, laboratory monitoring, and specific gender reassignment surgeries with detailed eligibility criteria. Coverage includes male-to-female and female-to-male transition surgeries but excludes cosmetic procedures like electrolysis, facial surgeries, and voice modification.
Action Required
Immediately: Billing team must implement prior authorization requirements for all gender reassignment surgeries for Maryland Medicaid patients. Verify patients meet all criteria including age 18+, 2+ years gender dysphoria diagnosis, 12 months hormone therapy (except mastectomy), and two independent psychological assessments with at least one doctoral-level provider. Update billing system to flag excluded cosmetic procedures as non-covered.