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PT 88-25: Primary Care Investment: E&M Increases
Effective date
Aug 1, 2025
Identified
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.
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What to do
Action · 5 steps
01Before August 1, 2025: For Maryland Medicaid providers -.
02FFS providers must upload ABMS board certifications in ePREP and complete PCP self-attestation via supplemental application.
03Update billing system to reflect enhanced rates for E&M codes 99202-99499 and G2211 for eligible primary care providers and behavioral health providers.
04Verify MCO contracts ensure minimum enhanced rate payments.
05Claims submitted on/after August 1 without proper PCP designation may receive lower reimbursement rates.
Codes mentioned
992029920399204992059921199212992139921499215992219922299223992319923299233992349923599236992389923999281992829928399284992859929199292993049930599306993079930899309993109931599316993189932499325993269932799328993349933599336993379934199342993439934499345993479934899349993509938199382993839938499385993869938799391993929939399394993959939699397994019940299403994049941199412994299944199442994439944499490994919949299493994949949599496994979949899499G2211
Original notice
PT 88-25: Primary Care Investment: E&M Increases
health.maryland.gov · Always check the source before changing claims.
Related changes
See all Maryland Medicaid changes →PT 66-26: Federally Qualified Health Center and Rural Health Center Coding GuidelinesHighEffective Mar 3, 2026 · CodingGeneral Provider TransmittalMediumNo effective date · General ProviderGE Modifier ClarificationHighNo effective date · Managed Care OrganizationsPT 49-26: GE Modifier ClarificationMediumEffective Jan 5, 2026 · Managed CareBrowse every Maryland Medicaid change in the policy list
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