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MedicaidReimbursementHigh impact

Maryland Medical Assistance Program Spring Updates 2015

Maryland Medicaid·MD·Provider Transmittal
Effective date
Jul 1, 2015
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid is increasing E&M reimbursement rates from 87% to 92% of Medicare rates effective July 1, 2015, and implementing ICD-10 coding requirements starting October 1, 2015. The policy also clarifies billing restrictions for technical/professional component services and provides updates on various Medicaid program changes.

Action Required

Action needed
By July 1, 2015: Update billing system to reflect new Maryland Medicaid E&M reimbursement rates at 92% of 2015 Medicare rates. By October 1, 2015: Prepare for ICD-10 implementation - Medicaid will begin accepting ICD-10 codes and will deny claims with diagnosis codes not coded to highest specificity level. Email dhmh.icd10f@maryland.gov to arrange end-to-end testing by July 31, 2015. Immediately: Review technical/professional component billing to ensure compliance - only bill for services actually performed by provider or employees, use appropriate modifiers (-TC for technical only, -26 for professional only).