A Benefit Coverage Determination Request is the process for asking Maryland Medicaid to add a new procedure, medical device, physician administered drug or biologic to its coverage.
A Benefit Coverage Determination Request is strictly for adding new coverage. It is
not a request to review or change existing Medicaid policy.
Maryland Medicaid
cannot review a request for experimental or investigational items or services.
Before You Submit a Request
Complete these steps to ensure your request is necessary.
- Check for existing coverage: Look up the item on the fee schedule for DME/DMS, laboratory services, or professional services.
- Check for pending requests: Use the Request Finder on this page.
Submit a Request
Use the online form to submit your request. You will get an email confirming we have received your form. Mobile Viewers Only: Go to the mobile request form now.
