MedicaidBilling CodesMedium impact
Proposed Amendment to COMAR 10.09.02 Physicians' Services
Maryland Medicaid·MD · Ophthalmology, Critical Care, Allergy & Immunology +1 more·Clinics
Effective date
Dec 29, 1997
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program (Medicaid) updated CPT-4 codes for 1997, eliminated preauthorization for eye exam codes 92004/92014/92015, removed coverage for sterilization reversal procedures, and updated critical care and allergy immunotherapy billing codes.
Action Required
Immediately: Update billing system to remove preauthorization requirements for CPT codes 92004, 92014, and 92015 eye exams. Replace deleted HCPCS W9200 with appropriate CPT E&M codes for medical problem exams. Stop using HCPCS M9999 for critical care and use CPT 99291-99292 or NICU codes 99295-99297 instead. Update allergy immunotherapy billing for codes 95144-95165 with correct unit limits (max 2 vials for 95144, dose count for 95145-95165). Remove sterilization reversal procedures from covered services.