MedicaidReimbursementHigh impact
PT 88-25: Primary Care Investment: E&M Increases
Maryland Medicaid·MD · Family Medicine, Internal Medicine, General Practice +2 more·Managed Care
Effective date
Aug 1, 2025
We identified it
Jun 18, 2026
Summary
Maryland Medicaid is implementing enhanced reimbursement rates for E&M codes 99202-99499 and G2211 for eligible primary care providers, effective August 1, 2025. This applies to MCO-designated PCPs, certain FFS providers, and behavioral health providers including psychiatrists and psychiatric nurse practitioners.
Action Required
Before August 1, 2025: For Maryland Medicaid providers - (1) FFS providers must upload ABMS board certifications in ePREP and complete PCP self-attestation via supplemental application, (2) Update billing system to reflect enhanced rates for E&M codes 99202-99499 and G2211 for eligible primary care providers and behavioral health providers, (3) Verify MCO contracts ensure minimum enhanced rate payments. Claims submitted on/after August 1 without proper PCP designation may receive lower reimbursement rates.