MedicaidBilling CodesMedium impact
Procedure Change - Modifier Required for Initial Medical Exam of Child in State-Supervised Care
Maryland Medicaid·MD · Pediatrics, Family Medicine·EPSDT
Effective date
Oct 1, 2010
We identified it
Jun 20, 2026
Summary
Effective October 1, 2010, Maryland EPSDT providers must use modifier '32' (Mandated Services) with preventive care CPT codes for initial medical examinations of children entering state-supervised care. This modifier ensures MCO payment obligation and allows non-participating providers to receive reimbursement at Medicaid Fee for Service rates.
Action Required
By October 1, 2010: Billing team must update system to append modifier '32' to age-appropriate preventive CPT codes (99381-99384, 99391-99394) for initial examinations of children entering state-supervised care only. Update encounter forms to remind providers this modifier applies only to initial visits, not subsequent visits. Ensure EPSDT certification is obtained before rendering services.