MedicaidCoverageMedium impact
Coverage of Emergency Room Facility Charges for Primary Adult Care Recipients
Maryland Medicaid·MD · Emergency Medicine·Hospital
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now covers emergency room facility charges for Primary Adult Care (PAC) recipients when they receive emergency services. This expands coverage for a specific Medicaid population that previously may have had limited ER facility charge coverage.
Action Required
Immediately: Billing team should verify patient eligibility for Primary Adult Care recipients in Maryland Medicaid before submitting ER facility charges. Update billing procedures to ensure proper claim submission for this population. Contact Maryland Medicaid for specific billing guidelines and any required modifiers for PAC recipients.