MedicaidBilling CodesHigh impact
Maryland Medicaid's New Dental Procedure Codes and Fee Schedule for Fee-For-Service Providers and HIPAA Update
Maryland Medicaid·MD · Dentistry, Oral & Maxillofacial Surgery·Dental
Effective date
Mar 1, 2004
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has updated to CDT-4 dental procedure codes and significantly increased reimbursement rates for 12 specific restorative procedures effective March 1, 2004. The policy also implements new HIPAA-compliant electronic billing requirements using X12N 837D transaction format.
Action Required
Immediately: Update billing system to use CDT-4 dental procedure codes for all Maryland Medicaid claims. Verify increased fee schedules for the 12 specified restorative procedures are applied. Complete HIPAA compliance testing and submit Trading Partner Agreement and Submitter ID forms to Rita Tate at 201 W. Preston St. Rm. LL3, Baltimore MD 21201. Begin using X12N 837D electronic format for dental claims submission. Continue using EVS system for eligibility verification and DHMH Form 234 for paper claims until further notice.