MedicaidCoverageMedium impact
Addition of Strattera (atomoxetine HCL) to the Mental Health Carve-Out
Maryland Medicaid·MD · Psychiatry, Pediatrics, Family Medicine +1 more·Managed Care Organizations
We identified it
Jun 20, 2026
Summary
Strattera (atomoxetine HCL) is being moved from medical benefit to mental health carve-out coverage, meaning claims will now be processed by the behavioral health vendor instead of the medical plan. This affects billing and prior authorization processes for ADHD medication management visits.
Action Required
Immediately: Billing team must verify mental health carve-out vendor information for patients prescribed Strattera and update billing workflows to route related evaluation and management claims to behavioral health plans instead of medical plans. Contact mental health vendors directly for prior authorization requirements and claims submission.