MedicaidReimbursementMedium impact
Reimbursement for Customized Equipment
Maryland Medicaid·MD · PM&R (Physical Medicine & Rehab), Orthopedics, Neurology +2 more·Medical Supply and Equipment
Effective date
Jul 1, 2005
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program implemented a distinct reimbursement methodology for customized medical equipment with no established Medicare rate. Providers can choose between manufacturer's suggested retail price minus 30% or wholesale cost plus 40% for truly customized equipment that is uniquely constructed for specific patients.
Action Required
Maryland Medicaid providers: Update billing procedures to apply enhanced reimbursement rates for customized equipment claims. Document that equipment meets COMAR 10.09.12.01 B(2) definition of customized (uniquely constructed/substantially modified for specific patient). Choose optimal reimbursement method: MSRP minus 30% or wholesale cost plus 40%. Contact DMS/DME/Oxygen specialist at 410-767-1739 for questions.