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MedicaidBilling CodesMedium impact

PT 78-26: Billing Requirement Update for Community Violence Prevention Services

Maryland Medicaid·MD · Emergency Medicine·Claims & Billing
Effective date
Apr 1, 2026
We identified it
Jun 18, 2026
Days to comply

Summary

Maryland Medicaid updated billing requirements for Community Violence Prevention (CVP) services effective April 1, 2026. CVP providers must now use CPT code 99402 for both initial and follow-up services, with specific place of service codes (19, 21, or 22) for initial encounters and appropriate telehealth modifiers (GT for visual-audio, UB for audio-only) when applicable.

Action Required

Action needed
Immediately: CVP providers must update billing systems to use CPT code 99402 for all initial and follow-up Community Violence Prevention services. Update place of service codes to 19, 21, or 22 for initial encounters based on service location. Add telehealth modifiers GT (visual-audio) or UB (audio-only) when services are provided via telehealth. Ensure provider enrollment includes required hospital affiliation documentation in ePREP system.

Affected Billing Codes

99402