MedicaidBilling CodesMedium impact
Proposed Amendments to COMAR 10.09.02 Physicians'' Services
Maryland Medicaid·MD · Family Medicine, Pediatrics, Internal Medicine +2 more·General Provider
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is incorporating 2001 CPT code changes and replacing local billing codes with standard CPT codes for EPSDT, Healthy Start, and nurse midwife services to comply with HIPAA requirements. The policy also expands supervision rules for certified nurse practitioners and anesthetists.
Action Required
Before December 17, 2001: Billing team must update Maryland Medicaid billing to use CPT codes 99381-99395 for full EPSDT screens instead of local codes, use CPT codes 99201-99215 for partial EPSDT follow-ups, add modifier -EP to procedure code 90173 for EPSDT vision screens, and stop using modifier -26 for VFC vaccine administration. Update billing system rules and encounter forms for Maryland Medicaid patients.