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

​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 

• 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, 2024
  
• 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 July 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 (Fillable PDF)​ (Updated March 2024)
• 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 5/1/24 updated 10/22/2024
  
• 2024 Professional Services Fee Schedule New Effective 1/1/24 - 4/30/24 updated 4/4/24​
  
• Environmental Lead Inspection 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​ 
• REM Case Management Rates​ Effective 01/01/24

Guidance - Other

• Urgent Care Facility Guidelines
  

Manuals - Other

• ​2024 Professional Services Provider Manual Effective 1/1/2024​ Revised 10/11/2024​​
• Podiatry Services Provider Manual  Revised April 2019
  
• School-Based Health Center Provider Billing Manual​ Revised August 2024
  

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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