MedicaidCoverageMedium impact
Emergency and Proposed Amendments to Hospital Services Regulations
Maryland Medicaid·MD · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Hospital
Effective date
Feb 2, 2000
We identified it
Jun 20, 2026
Summary
Maryland Medicaid will now reimburse hospital outpatient physical therapy, occupational therapy, speech therapy, and audiology services for children under 21 in Managed Care Organizations. The policy also removes second surgical opinion requirements and clarifies physician order entry systems for out-of-state providers.
Action Required
For Maryland providers: Update billing systems to accept revenue codes 420-429 (PT), 430-439 (OT), 440-449 (Speech), and 470-479 (Audiology) for Medicaid children under 21. Complete 'Therapy Services Plan of Care for Children' form at therapy onset and share with primary care provider. Maintain copies in both PCP and provider medical records. Provide quarterly updates to PCP. Use HCFA 1500 forms for home health and off-campus services, not UB-92. Hospital audiology programs must enroll as EPSDT providers but can bill on UB-92 using hospital provider number.