MedicaidPrior AuthMedium impact
Case Manager Preauthorization of Waiver Services
Maryland Medicaid·MD · Geriatrics, Occupational Therapy, Physical Therapy·Waiver for Older Adults
Effective date
Jun 4, 2003
We identified it
Jun 20, 2026
Summary
Maryland Medicaid Waiver for Older Adults now requires written preauthorization from Case Managers before submitting claims for Environmental Accessibility Adaptations, Assistive Devices, Environmental Modifications, and Assistive Equipment. Claims must be submitted on paper with signed preauthorization forms attached.
Action Required
Immediately: Billing team must obtain written Case Manager preauthorization before submitting any claims for codes GO207, GO214, GO218, and GO219. Attach signed preauthorization forms to all paper claims (DHMH 248 or HCFA 1500). Update billing workflow to verify preauthorization exists before claim submission. Claims without proper preauthorization will be denied payment.