MedicaidCoverageMedium impact
1915(i) Youth Peer Support Services Updates
Maryland Medicaid·MD · Psychiatry, Pediatrics·Behavioral Health Administration Services Organization
Effective date
Jul 6, 2026
We identified it
Aug 6, 2026
Summary
Maryland Medicaid is establishing new reimbursement for Youth Peer Support Services (YPSS) under the 1915(i) program, effective July 6, 2026. A new billing code (W9901) has been added at $28.40 per 15-minute unit with specific place-of-service and telehealth modifiers. Family Support Organizations must meet new provider enrollment requirements and obtain prior authorization before billing.
Action Required
By August 1, 2026 (before provider portal transition): (1) Billing team must update billing system to recognize new HCPCS code W9901 with rate of $28.40 per 15-minute unit and modifiers GT (audio-visual telehealth) and UB (audio-only telehealth). (2) Update billing workflow to require prior authorization through BHASO before submitting W9901 claims. (3) Providers must submit Youth Peer Support Provider Application to BHASO at MD1915i@carelon.com before system transitions to MPRIME in October 2026. (4) Update provider enrollment portal with required documentation: YPSS BHA Approval Letter, completed application, Maryland Peer Recovery Specialist Certification, personnel policy on peer employment, and staff credentials list. (5) Existing PT 89 providers submit supplemental application; new providers submit new PT 89 application. (6) Configure place-of-service validation for codes 11, 12, and 99 only. Note: Maryland Medicaid is pausing all applications from August 1, 2026 until MPRIME goes live in October 2026—plan accordingly.