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Maryland MedicaidMedicaid · Coverage · Claims & Billing · MD · Pediatrics, Family MedicineLow impact

PT 47-26: Lead Paint Risk Assessor Billing

Effective date
Oct 1, 2025
Identified
Jun 18, 2026

Summary

Maryland Medicaid lowered the blood lead level threshold for environmental lead investigations from 5μg/dL to 3.5μg/dL, effective October 1, 2025. Lead Paint Risk Assessor organizations can now bill code T1029 at $418.49 per dwelling for children under 21 with elevated blood lead levels. This policy supersedes previous guidance PT 16-20 from 2019.

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What to do

Action · 3 steps
01Maryland providers only: If your practice performs environmental lead investigations, enroll as Lead Paint Risk Assessor provider through ePREP using NPIs with taxonomies 247200000X and 251K00000X.
02Update billing system to use code T1029 ($418.49) for comprehensive environmental lead investigations for Medicaid children under 21 with blood lead levels ≥3.5μg/dL.
03Verify Medicaid eligibility before service delivery through eMedicaid system.

Codes mentioned

T1029

Original notice

PT 47-26: Lead Paint Risk Assessor Billing
health.maryland.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Maryland Medicaid changes →
Lead Paint Risk Assessor BillingMediumEffective Oct 1, 2025 · EPSDTBrowse every Maryland Medicaid change in the policy list

Related policy hubs

Maryland Medicaid policiesMD policy changesPediatricsFamily MedicineCode T1029

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