MedicaidPrior AuthMedium impact
Proposed Amendments 10.09.02
Maryland Medicaid·MD · General Surgery, OB-GYN, Orthopedics +3 more·Physicians
Effective date
Mar 6, 2000
We identified it
Jun 20, 2026
Summary
Maryland Medicaid eliminated the second surgical opinion requirement for certain elective surgeries including cholecystectomy, hysterectomy, and spinal fusion. The policy also updated to 1999 CPT-4 codes and replaced local procedure codes with standard J-codes and CPT codes.
Action Required
Immediately: Stop requiring second surgical opinions for elective surgeries including cholecystectomy, hysterectomy, transurethral prostatectomy, tonsillectomy, discectomy, spinal fusion, coronary artery bypass, arthroplasty, and elective cesarean section for Maryland Medicaid patients. Update prior authorization workflows to remove this requirement. Replace any local Y-codes, Z-codes, and hospital outpatient codes with standard J-codes and CPT codes in billing systems.