MedicaidReimbursementMedium impact
Adoption of Proposed Amendments to COMAR 10.09.15 Podiatry Services
Maryland Medicaid·MD · Podiatry·Podiatrist
Effective date
Jun 14, 1999
We identified it
Jun 20, 2026
Summary
Maryland Medicaid updated podiatry service regulations to allow podiatrists to be reimbursed on the same payment basis as physicians and advanced practice nurses, and revised the fee manual through 1999 CPT-4 codes. The policy includes specific billing requirements for routine podiatric care limited to diabetic and peripheral vascular disease patients every 60 days.
Action Required
Maryland billing teams must update podiatry billing procedures to: 1) Use CPT codes 11055-11057 and 11719 only for routine care when no other services are provided, 2) Enter treating physician's name and UPIN on line of HCFA-1500 for routine care claims, 3) Use diabetes/peripheral vascular disease as primary diagnosis with podiatric diagnosis as secondary for routine care, 4) Apply modifier -50 for second and subsequent surgical procedures at same session with 50% payment reduction, 5) Limit routine care billing to once every 60 days for qualifying patients.