​Find fee schedules provider and program guidance, manuals and forms.​ See Provider Quick Links to access more information and resources.​​

Maryland Medicaid Renewals 

During the COVID-19 public health emergency, Marylanders who were enrolled in Medicaid continued to be covered, even if they were no longer eligible. Starting in April 2023, Maryland began making Medicaid eligibility reviews again. Not everyone will be up for renewal at the same time. These renewals will take place over 12 months.​ Learn more, see Provider Check-In page. 

Audiology Services

• Audiology, Physical Therapy, and Early Periodic, Screening, Diagnosis and Treatment (EPSDT) Provider Manual  Effective January 1, 2024​​
  
• Audiology Clinical Criteria  Effective October 1, 2020
• Audiology Provider Memo  April 2019
• Audiology Corrections Memo  December 2018
• Audiology MCO Preauthorization Contacts List  2019
• Audiology Parent Q & A  English
• Audiology Parent Q & A  Spanish

Behavioral Health

The Department's designated Administrative Service Organization must authorize Behavioral Health services, Optum.

• PBHS Fee Schedules  
• Residential Substance Use Disorder Treatment for Adults
• 1915(i) Information
• Health Homes Information

Dental and Laboratory 

• Medical Laboratory Fee Schedule 2024 (PDF) Effective April 1, 2024 updated 4/5/2024
  
• Medical Laboratory Fee Schedule 2024 (Excel) Effective April 1, 2024 updated 4/5/2024
  
• Medical Laboratory Fee Schedule 2023 (PDF)  Effective February 1, 2023 updated 11/15/2023
  
• Medical Laboratory Fee Schedule 2023 (Excel) Effective February 1, 2023 updated 11/15/2023
  
• COVID-19 Reimbursable Laboratory Codes Fee Schedule
  
• Laboratory Preauthorization Decision Procedure
• 2024 Dental Fee Schedule and Procedure Codes Effective January 1, 2024​
  
• 2023 Dental Fee Schedule and Procedure Codes Effective August 1, 2023
  
• 2023 Dental Fee schedule and Procedure Codes Effective April 1, 2023
• 2022 Dental Fee Schedule and Procedure Codes  Effective July 1, 2022
• 2022 Dental Fee Schedule and Procedure Codes  Effective January 1, 2022
  

Early Periodic Screening Diagnosis and Treatment (EPSDT) - Healthy Kids 

• Applied Behavior Analysis (ABA) Fee Schedule Effective July 1, 2022
• Audiology, Physical Therapy, and Early Periodic, Screening, Diagnosis, and Treatment (EPSDT) Provider Manual Effective January 1, 2023
• Maryland Healthy Kids Program
• Medicaid Policy & Procedure Manual for Services Delivered through the IEP/IFSP Effective January 1, 2024​​

Hospice Services

• Maryland Medical Assistance Hospice Program Rates (Fiscal Year 2015)
• Maryland Medical Assistance Hospice Program Rates (Fiscal Year 2016)

Nursing Services

• Nursing Services Policy Manual (2017)
• Division of Nursing Services Contact Information
• Division of Nursing Services Preauthorization Process - 2021

Reproductive Health Providers

Maryland Medicaid Overview (Updated October 2023)

• Factsheet #1: Self-Referral Provisions
  
• Factsheet #2: Family Planning Services
• Factsheet #3: Medicaid Family Planning Program
  
• Factsheet #4: Long-Acting Reversible Contraceptives (LARCs)
  
• Factsheet #5: Permanent Sterilization
  
• Factsheet #6: Abortion Services (Updated October 2023)
  
• Factsheet #7: ​​Obstetrics and Gynecology (OBG​YN)​
  
• Maryland Prenatal Risk Assessment (Updated December 2022)
• Enriched Maternity Services Form (Updated February 2022)
  
• Physician Forms for Hysterectomy, Sterilization, and Preauthorization
  
• ​​​Document for Hysterectomy- MDH 2990
  
• Sterilization Consent Form - HHS-687
• Sterilization Consent Form (Spanish) -HHS 687-1
• Freestanding Birth Center Facility Fee Schedule

Fee Schedules – COVID-19

• COVID-19​ Reimbursable Laboratory Codes Fee Schedule
  
• COVID-19 Reimbursable Vaccine and Infusion Codes Fee Schedule
  
  

Fee Schedules - Other 

• 2024 Professional Services Fee Schedule New Effective 1/1/24 updated 4/4/24
  
• COVID-19 Reimbursable Vaccine and Infusion Codes Fee Schedule
  
• Environmental Lead Inspection Fee Schedule
• HIV Case Management Fee Schedule
• Monkeypox Vaccine and Administration Fee Schedule
• Nursing Services Program Rates – Fiscal Year 2020 Effective 7/1/19
• Private Duty Nursing/Home Health Aide Fee Schedule 

Guidance - Other

• Urgent Care Facility Guidelines
• Billing Instructions for ADAA Certified Addictions Outpatient Program Providers

Manuals - Other

• 2024 Professional Services Provider Manual  Effective 1/1/2024
  
• Podiatry Services Provider Manual  Revised April 2019
  
• School-Based Health Center Provider Billing Manual Revised October 2023
  

Medicare Advantage

• Medicare Advantage Plan Billing Instructions for CMS-1500
• Medicare Advantage Plan Billing Instructions for UB04
• Medicare Advantage Plan Cost Sharing Memorandum

Miscellaneous Information 

• 1184 E-Medicaid Newborn Processing Instructions  Effective April 2012
• Drug Formularies
• Health Information Portability and Accountability Act (HIPAA) Resources
  
• Request for New Medicaid Coverage Consideration for Procedures, Devices and Drugs/Biologics

Preauthorization

• Professional Services Preauthorization Information Effective 1/1/19​
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