MedicaidPrior AuthHigh impact
Preauthorization
Maryland Medicaid·MD·Home Health
Effective date
Sep 19, 2005
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has clarified preauthorization requirements for home health services, specifying when prior auth is needed (multiple visits per day, services over $5,611.50 in 30 days, 4+ hours of care daily, mental health services, and home health aide services without skilled nursing). This transmittal supersedes previous guidance and outlines emergency/urgent service exceptions.
Action Required
Immediately: Home health agencies must obtain preauthorization via phone (410-767-1448) before service initiation for: multiple visits per service type per day, anticipated payments over $5,611.50 in 30 days, 4+ hours daily care, mental health services, and home health aide services without skilled nursing. Update intake processes to identify these scenarios. Obtain written physician orders before billing Medicaid. Emergency/urgent services require preauth by next business day.