MedicaidReimbursementMedium impact
Changes to Pharmacy Dispensing Fee and Copayment for Prescriptions
Maryland Medicaid·MD · Pharmacy·Pharmacy
Effective date
Jul 1, 2004
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is changing pharmacy dispensing fees and adding new copayments for prescriptions effective July 1, 2004. Generic drugs and preferred brand drugs will have a $1.00 copayment (previously $0), while non-preferred brand drugs maintain a $2.00 copayment.
Action Required
By July 1, 2004: Billing team must update pharmacy billing systems to reflect new dispensing fees ($3.69 for generic/preferred drugs, $2.69 for non-preferred drugs, higher rates for nursing home patients) and implement $1.00 copayment collection for generic and preferred brand drugs for Maryland Medicaid fee-for-service patients. Update patient collection procedures to exempt children under 21, pregnant women, nursing home residents, and family planning prescriptions from copayments.