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Medicaid Fee-for-Service Payment of Medically Necessary Ancillaries on Administrative Days
Act
by Mar 31, 2026
Effective date
Jan 1, 2026
Identified
Jul 11, 2026
Summary
Maryland Medicaid FFS updated its policy on billing ancillary services (labs, imaging, dialysis, respiratory services, EKG) during Administrative Days. Medical/surgical supplies are no longer covered on Administrative Days as costs are incorporated into the base rate. Hospitals must document medical necessity, complete the MDH 1288 form with placement activities, and request retrospective UCA review. Revenue codes for BMP and CMP have been updated to 0301.
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What to do
by Mar 31, 2026 · 8 steps
01Hospital billing teams must.
02Remove medical/surgical supplies from all Administrative Day ancillary billing requests and verify they are no longer submitted with Admin Day claims.
03Update billing system revenue code mappings to use 0301 for both BMP (CPT 80048) and CMP (CPT 80053) ancillaries on Administrative Days.
04Train billing staff on the complete list of 13 covered ancillaries (labs, radiology, cardiology, renal, respiratory services) and ensure only these services are billed on Admin Days.
05Implement workflow requiring completion of MDH 1288 form with documented placement activities (minimum 2 per Admin Day) before submitting retrospective review to UCA.
06Update internal policies to reflect this change supersedes PT 11-25.
07Billing team must verify all Administrative Day claims include only eligible ancillaries or they will be denied by UCA.
08Contact mdh.acutehospitalpolicy@maryland.gov for clarification.
Codes mentioned
80048800538502585610837358410082310710467401874150741607046071260
Original notice
Medicaid Fee-for-Service Payment of Medically Necessary Ancillaries on Administrative Days
health.maryland.gov · Always check the source before changing claims.
Related changes
See all Maryland Medicaid changes →Payment of Medically Necessary Ancillaries on an Administrative DayHighEffective Jul 1, 2024 · HospitalPT 67-26: Medicaid Fee-for-Service Payment of Medically Necessary Ancillaries on Administrative DaysMediumEffective Jan 1, 2026 · Claims & BillingMedicaid Coverage for Radiological and Imaging Services Provided by Certified Nurse PractitionersMediumEffective Jul 1, 2025 · Managed Care OrganizationsPT 07-26: Medicaid Coverage for Radiological and Imaging Services Provided by Certified Nurse PractitionersMediumEffective Jul 1, 2025 · Managed CareBrowse every Maryland Medicaid change in the policy list