MedicaidAdministrativeMedium impact
Carve-out of Substance Use Disorder (SUD) Medications
Maryland Medicaid·MD · Psychiatry, Family Medicine, Internal Medicine +1 more·Provider Transmittal
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is carving out substance use disorder (SUD) medications from managed care plans, meaning these medications will now be covered directly by fee-for-service Medicaid instead of through MCOs. This affects billing and prior authorization processes for SUD medications.
Action Required
Review current SUD medication billing processes and prepare to transition from MCO billing to direct Maryland Medicaid fee-for-service billing. Contact Maryland Medicaid for specific implementation timeline and updated billing procedures for SUD medications.