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MedicaidPrior AuthMedium impact

Fee Schedule for Fiscal Year 2014

Maryland Medicaid·MD · Psychiatry, Pediatrics·Personal Assistance/Care Services
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid has expanded peer review pre-authorization requirements for antipsychotic medications prescribed to youth under 18 years old. This affects psychiatric and pediatric practices billing for antipsychotic drug prescriptions in Maryland.

Action Required

Action needed
Psychiatry and pediatric providers in Maryland must obtain peer review pre-authorization before prescribing antipsychotic medications to patients under 18 years old. Update EMR systems to flag these prescriptions and ensure prior authorization is obtained before dispensing. Failure to obtain pre-authorization may result in claim denials for associated visits and medication coverage.