MedicaidCoverageMedium impact
Coverage, Ordering, and Billing of HIV-1 Viral Load Tests
Maryland Medicaid·MD · Infectious Disease, Internal Medicine, Family Medicine·Managed Care Organizations
Effective date
Jul 1, 1997
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program (Medicaid) will reimburse HIV-1 viral load tests regardless of patient's MCO enrollment. MCOs must provide proper ordering documentation including patient Medical Assistance number and authorized practitioner information for billing.
Action Required
For Maryland Medicaid patients: When ordering HIV-1 viral load tests through MCOs, ensure MCO provides patient's Medical Assistance number, ordering practitioner's Maryland Medical Assistance provider number, and signed order from authorized practitioner. Use code W0913 for dates of service July 1, 1996 through June 30, 1997, and G0100 for dates beginning July 1, 1997. Attach laboratory report with test results and methodology for reimbursement.