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    Fee-For-Service Claims Guidance

    ​FInd  information on submitting fee-for-service claims to Maryland Medicaid. For managed care organization (MCO) billing requirements, contact the Medicaid participant’s MCO.

    • A provider must submit a clean claim to Maryland Medicaid within 12 months of the date of service or discharge, depending on the rules for their provider type. 

    • If a provider initially submitted timely and received a rejection or denial, they must submit a clean, corrected claim anytime within 12 months from the date of service or discharge, whichever applies.

    For more information on Maryland Medicaid’s billing time limitations, see COMAR 10.09.36.06

    How to Submit a Fee-for-Service Claim

    Professional Claims Billing Guidance (CMS 1500)

    Institutional Claims Billing Guidance (UB-04) 

    ​Healthcare Code Sets for EDI Transactions

    Maryland Medicaid uses Centers for Medicare and Medicaid (CMS)-designated code sets for diagnoses and procedures used in all transactions.

    Provider Payment - Register for Electronic Funds Transfer (EFT) or Change Bank Account Information 

    Maryland Medicaid makes all provider payments by electronic funds transfer (EFT) through the Comptroller of Maryland. For more information, or to register with the EFT program or change bank account information, visit www.marylandtaxes.gov/divisions/gad/eft-program.php.

    Contact

    For additional information or assistance, call the Provider Services Call Center​.

     FAQs