MedicaidCoverageMedium impact
PT 21-26: Continued Medicaid Coverage of COVID-19 Vaccines for Adults
Maryland Medicaid·MD · Family Medicine, Internal Medicine, General Practice +2 more·Medical Policy
Effective date
Sep 19, 2025
We identified it
Jun 18, 2026
Summary
Maryland Medicaid will continue covering medically necessary COVID-19 vaccines for adults aged 19+ regardless of underlying medical conditions, following recent ACIP guidance changes that moved to shared decision-making recommendations. Both Fee-For-Service and HealthChoice MCOs must reimburse in-network providers for these vaccines when medically necessary.
Action Required
Immediately: Billing team should verify that COVID-19 vaccine claims for Maryland Medicaid patients aged 19+ continue to be processed normally, ensuring medical necessity is documented in patient records. Providers should document shared decision-making discussions and refer to evidence-based professional society guidelines when determining medical necessity for vaccine administration.