Maryland Department of Health
Office of Population Health Improvement

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Local Health Department Billing Manual

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Overview
With so many important resources available, this section is an archive of prior information that remains relevant. 
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Document Title
062317 DHMH Opioid DUR SBIRT
10 Common Medical Billing Mistakes That Cause Claim Denials
12 Signs It's Time to Change Your Clearinghouse
2014 MCO Appendix B Amendment to HealthChoice Provider Service Agreements
2016 MDH Contracting Letter to LHDs
​2019 AAP - Coding for Pediatric Preventive Care
2019 AAP - Coding for Pediatric Preventive Care -
2020 Title X Job Aid FPNTC Copay Job Aid
2021 CPT MPFS Update Worksheet​
2021 Healthy Smiles Provider Manual
2021 MD Medicaid Medical Laboratory Fee Schedule 2.16.21
​2021 Medicaid Professional Services Fee Schedule 1.1.21 UPDATED 3.10.21
340B Compliance Self-Assessment Policy
340B Drug Pricing Program Infographic
340B Family Planning Guide​
340B Family Planning Policy Procedure Manual​
340B Family Planning Policy Procedure Manual (Sample)
99211 Checklist
A Guide to Cigna's Preventive Health Coverage for Health Care Professionals
AAP Adolescent Confidentiality​ ​​​
AAPC 2019-2020 Influenza Vaccine Codes and Pricing
AAPC Health Plan Search: Provider Manuals and Policies
AD New Requirements Certification Licensure - Effective October 1, 2015
Administrative Functions
Administrative Guide: Pass-through Billing, CLIA Requirements, Reimbursement Policy
Adult Immunizations Reimbursement Survey - Medicaid MCOs
Adult Vaccine and NDC List - 2019
Advantage MD (HMO) Quick Reference Guide - 2020
Advantage MD (PPO) Benefits Comparison​ Chart - 2020
Advantage MD Provider Manual - 2020
Aetna 2020 Behavioral Health Provider Manual
Aetna Behavioral Health Provider Manual 2021
Aetna Better Health COVID Televideo Codes March 2020​
Aetna Better Health COVID-19 FAQs for Network Providers​ April 2020
Aetna Better Health Healthchoice Provider Manual 2021
Aetna Better Health MCO
Aetna COVID March 2020
Aetna Dental and Oral Surgery Claim Documentation Guidelines
Aetna Essentials April 2022
Aetna Office Link February 2022
Aetna Office Link January 2022
Aetna Office Link Updates December 2021
Aetna Office Link Updates June 2021
Aetna Office Link Updates March 2022
Aetna Office Link Updates September 2021
Aetna OfficeLink May 2022​
Aetna Officelink Updates June 2022​
Aetna Provider Communication June 2022​
Aetna Provider Communications​
Aetna Update on the COVID-19 Vaccine
Aetna Update onthe COVID-19 Vaccine
Aetna Vaccine Provider Communication​
​Affordable Care Act: Young Adult Insurance Coverage FAQs​​
Alcohol and Drug Requirements Certification Licensure
AMA Announces CPT Update for Pediatrics​
AMA CPT Coding Alert Covid Booster Updates May 2022​
AMA CPT Coding Alert Covid Booster Updates May 2022​
AMA cpt Emergency Release COVID Related Code File
AMA CPT Emergency Release COVID Related Code File
AMA CPT Update New Provisional COVID Vaccine Code
AMA E and M 2021 Coding Changes
AMA E&M 2021 Coding Changes
AMA New Codes for COVID Immunizations
AMA Technical Corrections 2021
AMA Technical Corrections 2021 EM Updates
AMA_ CPT NEWS ALERT
AMA: Telehealth Implementation Playbook
Amerigroup Medicaid Botox Update​​​
Amerigroup Medicaid Provider Newsletter Dec. 2021
Amerigroup Provider Manual 2021
Amerigroup Provider Newsletter January 2021
Amerigroup Provider Newsletter Nov 2021
Amerigroup Provider Newsletter Oct. 2021
​Amerigroup SBIRT​
Amerigroup SBIRT Flier
Amerigroup Sexually Transmitted Disease Services Lab​
Any DATA 2000 Waived Practitioner (MD, NP, PA) and Local Health Department with DATA 2000 Waived Practitioners - May 15, 2017
Appeals and Grievance Form - May 20, 2014
Audiology, Physical Therapy, and Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Provider Manual​
Audiology, Physical Therapy, and EPSDT Provider Manual - Final 7-8-20
Audiology, Physical Therapy, and EPSDT Provider Manual - Final July 8, 2020​
​Audiology, Physical Therapy, and SPSDT Provider Manual Final 7.8.20
Authorization Quick Reference Guide - June 2017
Authorization to Disclose Substance Use Treatment Information Coordination of Care Form
Availity Portal FAQs - 2017
Beacon Billing Intermediary Authorization Form​
Beacon CAQH Provider Credentialing Recredentialing FAQ​
Beacon Health Options Outpatient Mental Clinics Rendering Provider Requirements for Claims Submission - April 12, 2019
Beacon Maryland Provider eNewsletter May 2016
Beacon Memo: Provider Registration Update - December 16, 2019
Beacon OTP Compliance
Beacon Provider Alert: SUD OMS Discharge Service Code - June 2018
Beacon Provider Credentialing Criteria Checklist
Beacon Reimbursement - 2020
Beacon SUD Discharge FAQ - 06-21-2018
Beacon SUD Discharge FAQ (90889/HG)
Beacon SUD Discharge Form & Process 6.21.18
Beacon SUD Transmittal 25 Q & A IOP PHP Drug Testing 5.29.19​
Beacon SUD Uninsured Grant Funded Individuals Revised 06-03-16
Beacon Tip Sheet: FIS Claim Rejection Messages​
Beacon to Optum MDH Transition FAQs 12.6.2019
Beacon to Optum Transition Information EOY
Beacon Value Option Group Practice Tip Sheet
Behavioral Health Provider Manual - 2020
Behavioral Health Services - Common Billing Codes
Behavioral Health Services Common Billing Codes
Better Health of Maryland: Provider Guide - March 5, 2019
BHA Clinical Letter Help the Helpers Supports Overview 3.8.21
BHA Memo: Guidance Regarding Telehealth Expansion Regulations - March 12, 2020​
Billing and Coding Manual for Title X Family Planning Clinics
Billing Behavioral Health Services
Billing Coding Guide for HIV Prevention
Billing Credentialing Physician Extenders (Nurse Practitio ners and Physician Assistants) ​
Billing for HIV Services
Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service​​
Billing for Telehealth Program Manual-Updated
Billing for Vaccines for Children Program
Billing Immunization Services
Billing Software Clearinghouse Checklist​
BlueLink Final2 December 2020
Buprenophine New Rates Retro Effective 01012018 Provider Alert
CAQH Provider Credentialing Database Intro
CAQH Provider Use Guide V7 2016
CAQH Proview Provider User Guide V32
Cardea: A Coding Guide for Programs and Providers​
Care Management
CAREFIRST _ COVID VACCINE BILLING
CareFirst BlueLink April 2021​​
CareFirst BlueLink February 2021
CareFirst CO
​CareFirst Community Plan 2021 Medical Provider Manual
CareFirst Community Plan Provider Manual​
CareFirst COVID Testing TX Extending Coverage 9.24.20
CareFirst COVID Vaccine Billing
CareFirst COVID-19 Dental
CareFirst Dental CVID-19
CareFirst March 2020 COVID-19 CEO Message & Info
CareFirst MD Preserve Telehealth Access Act Provider Alert
CareFirst New Address
CareFirst on Call: Professional Reference Card - August 2018
CareFirst Provider Manual 2021
CareFirst: Dental Claims Submission Guidelines​
CareFirst/Johns Hopkins University Members Changed Plans Effective 1.1.2021
Case Management and Disease Management
CCU Modernization Project - July 2018
CDC and OPA 2017 Recommendations Providing Quality Family Planning Services
Central Collection Unit (CCU) COMAR Regulations
Challenges to Patient Confidentiality Infographic​
Change-Healthcare Fact Sheet 2021
Checklist for Examining Your Claims Process
CHP MDID Card
Cigna _ Transformations _ COVID-19_ Interim guidance for behavioral providers
Cigna 1st Quarter 2021 Newsletter
Cigna Continued COVID Accommodations
Cigna Coronavirus Billing Guidance FAQ
CIGNA COVID -19 PHE Extension
Cigna COVID PHE Extends
Cigna COVID-19 PHE Extension
Cigna COVID-19 Update April 2021
Cigna COVID-19 Update July 28, 2020
Cigna COVID-19 Vaccine Reimbursement Flyer
Cigna Cyberthreat Information 11.2020
Cigna Dental Services COVID-19
Cigna January 2021 Update
Cigna July 2020 COVID-19 Updates
Cigna Key COVID-19 Updates for Sept. 2021
Cigna Key COVID-19 Updates for September 2021​​​
Cigna Medicare Advantage Provider Manual 2021
Cigna Member ID Cards
Cigna Network News 1st Quarter 2022
Cigna Network News 4th Quarter 2021​​​​​​
Cigna Network News Q3 2021​
Cigna Network News Q4
Cigna News COVID Accommodation
Cigna Provider Manual 2021
Cigna Q2 2021 Network News
Cigna Q4 Network News Posting v5
Cigna Transformations COVID 19 Interim Guidance for Behavioral Providers
Cigna Transformations COVID-19 Interim Guidance for Behavioral Providers
Cigna Update December 2020
Cigna Update EXT PHE 042 2021
Cigna Virtual Care Reimbursement Policy
Claim Retraction Policy - October 2018
Claim Submission
Claim Submission Guide​
Claim Submission Instructions - November 28, 2017
Claims and Encounter Data Submissions - 2020
​Claims Processing
Clearinghouse Functions and Benefits​​
Clinical Criteria for Hepatitis C Therapy
CMS - Pneumococcal Conjugate Vaccine Coverage
CMS 12 .2014 Memo MA Payment FFS Provided Without Charge Free Care
CMS 1500 Claim Form – How to Avoid Common Denials
CMS Addition of QW Modifier
CMS Announcement ICD 10 MS DRGs V39.1 New Procedure Codes
CMS Announcement ICD10 MS DRGs V39.1 New Procedure Codes
CMS August 19, 2020 Telehealth Presentation
CMS Behavioral Health Services Fact Sheet
CMS Billing for Methadone 1.20.21
CMS CDC HRSA Bulletin: Opportunities to Improve HIV Prevention and Care Delivery to Medicaid and CHIP Beneficiaries​​
CMS Checking Medicare Eligibility
CMS Consolidated Appropriations Act of 2021 Provider Requirements and Resources
CMS COVID-19 Vaccine Toolkit 11.23.2020
CMS HHS Medicare Advantage COVID-19 Memo March 10, 2020
CMS HIV Screening Codes
CMS Home Health Prospective Payment System Rate Update MM12509
CMS Informational Bulletin: 2019 Federal Poverty Level Standards - February 11, 2019
CMS Medicaid SUD & Mental Health Parity Final Rule 3.29.16 FAQs
CMS Medicaid SUD & Mental Health Parity Final Rule FAQs
CMS Medicare and Medicaid Basics
CMS Medicare Monoclonal AB COVID Program Instruction
CMS Memo: Implementation of Section 5052 of the Support for Patients and Communities Act – State Plan Option under Section 1915(l) of the Social Security Act
CMS MLN 006818 2021 12 Clinical Laboratory Fee Schedule 508
CMS MLN COVID FFS SE20011 11.9.20
CMS MLN COVID-19 Vaccine 11.5.2020 Final
CMS MLN How to Use NCCI Medicaid
CMS MLN Opioid Treatment Programs
CMS Monoclonal Antibody Coverage Infographic
CMS PECOS Multi-factor Authentication
CMS Summary Sheet on Bundled Payments for Behavioral Health Integration Services
CMS Telehealth Codes Updated January 2022
CMS Will Pay for COVID-19 Booster Shots
CMS_ ADDITION OF QW MODIFIER_ MM12269_
CMSC Informational Bulletin: Aligning Dental Payment Policies and Periodicity Schedules in the Medicaid and CHIP Programs
Code J1050 Depo Provera ACOG
Coding and Billing Bicillin LA and CR
Coding for Pediatric Preventive Care
​​Coding for Vaccine Administration
Collecting Copays and Applying A Sliding Fee Discount Schedule
COMAR 10.09.32 Targeted Case Management for HIV Infected Individuals
COMAR 10.09.32. Targeted Case Management for HIV-Infected Individuals
COMAR 10.09.71.04 E: MCO Notification of Denials to Patients - 2018
COMAR 10.63 Key Personnel​
Combination of SUD Services - Effective July 1, 2017​
Community-Based Substance Use Disorder Fee Schedule - May 6, 2020​
Community-Based Substance Use Disorder Fee Schedule - Updated May 6, 2020
Comparison of 2019 and 2021 Final Title X Rules
Confidentiality Issues STI 15-25 yrs.​ mm6609
​Contact Information - 2020
Coronavirus (COVID-19) Interim Billing Guidance for Commercial Customers - April 9, 2020
Covid 19 Vaccines and Monoclonal Antibodies
Covid 19 Vaccines and Monoclonal Antibodies​
COVID AMA Webinar Coding and COVID 19 Vaccine​
COVID Antibody Treatment Form for Maryland 2021
COVID Best Practices & Resources​
COVID CMS 99211 CPT Code Update
COVID CMS Toolkit on COVID-19 Vaccine: Health Insurance Issurance Issuers and Medicare Advantage Plans
COVID CPT Assistant Guide 99072 September 2020​​
COVID December Update
COVID Fact Sheet Recovery and Wellness Support​
COVID Facts BHA Partners 8.14.2020​
COVID FAQs Telehealth 1.19.2021
COVID ImmuNet COVID-19 Vaccine Registration Order Guide
COVID ImmuNet COVID-19 Vaccine Registration Order Guide​
COVID ImmuNet COVID-19 Vaccine Registration Order Guide
COVID January 2021 Update
COVID Student and Young Adult Resource Guide for Coping During COVID-19
COVID Student and Young Adult Resources Guide for Coping During COVID-19
COVID Vaccine Provider Communication
​COVID-19 Billing Information​​
COVID-19 CMS Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing
COVID-19 Coding Guidelines 2021
COVID-19 FAQs for Network Providers - April 2020
COVID-19 Information for Dental Providers
COVID-19 NDC HCPCS Crosswalk Update
COVID-19 New Administration Code for Pfizer Pediatric Vaccine Booster Dose
COVID-19 Power Point Slides April 22, 2020​
COVID-19 Public Health and Medical Emergency Declarations and Waivers
COVID-19 Reimbursable Laboratory Codes Fee Schedule Update​​​​​​
COVID-19 Reimbursable Laboratory Codes Fee Schedule Update 1.12.21
COVID-19 Reimbursable Vaccine and Infusion Codes Fee Schedule
COVID-19 SR Health Seeing Patients Virtually Getting Paid Guide May 14, 2020​
COVID-19 Telehealth Checklist FY2020
COVID-19 Telehealth Guidance for School-Based Health Centers
COVID-19 Teleheatlth Guidance for School-Based Health Centers
COVID-19 UHC Date Provision Guide
COVID-19 UHC Provider Billing Guidance​
COVID-19 Update FDA Authorization​​
COVID-19 Vaccination Registration through ImmuNet JHHC​
COVID-19 Vaccine Billing and Coding​
Delegation Provider Guide - February 2020
Delta Dental COVID-19 August 18, 2020 Updates​
Dental and Oral Surgery Claim Documentation Guidelines - April 2019
Dental Procedure Codes and Nomenclature (CDT Codes)
Dental Program - 2020
DHMH Substance Use Disorder Services
Dual Eligible Medicare and Medicaid 2020 Standards
ECP LHD Amendment to Instructions on Essential Community Providers
ECP LHD Amendment to Instructions on Essential Community Providers​​
ECP LHDs Amendment to Instructions on Essential Community Providers
Electronic Health Record - Health IT Playbook
Electronic Payment Solutions - 2020
Electronic Remit Advice (ERA) and Standard Paper Remit (SPR)
Eligibility Verifica​​​tion System (EVS) Brochure - October 2019
Emdeon: Clearinghouse Brochure Example
eMedicaid Main Screen: Provider Welcome
Ensuring Access to Equitable Affordable Client Centered
EPSDT Provider Policy Manual - Effective 7-1-18
EPSTD Provider Policy Manual Effective 7.1.18
EPT Fact Sheet for Health Care Providers FINAL as of 3.19.19
Essential Community Provider Data Form
Evaluation Management Coding Job Aid
Expedited Partner Therapy
Expedited Partner Therapy​​
EZ Coder - Adult Immunization and Well Visit
EZ Coder - Child and Adolescent and Well Visit
Fact Sheet #7: OB/GYN Services
Fact Sheet 2017 The Ryan White HIV/AIDS Program - The-Basics
Fact Sheet: The Ryan White HIV/AIDS Program - The Basics​​​​​​
Fact Sheet: The Ryan White HIV/AIDS Program - The Basics
Fact Sheet: The Ryan White HIV/AIDS Program - The Basics​
Family Planning CCU Collection FAQs
Family Planning Chart - What Makes a FP Patient
Family Planning Coding Frequently Asked Questions Title X
Family Planning Coding Frequently Asked Questions Title X​​​​
Family Planning COVID-19 Social Media Toolkit April 2020 FPNTC
Family Planning NACHC
Family Planning Revenue Cycle Assessment Tool
FINAL BHA Telehealth Post Emergency Revised​
Flu 2020-2021 Reference Chart
Forms
FPNTC Collecting Co-Pays and Applying Sliding Fee Discount Schedule Job Aid
FPNTC Family Planning and Related Health Services for Men Checklist
FPNTC Family Planning and Related Health Services for Women Checklist
FPNTC Financial Management Change May 2020
FPNTC Title X Telehealth Staffing Steps Outline 8.21.20
​​Front Office Training Checklist​
​FY 2021 Ability to Pay Outpatient Memo
FY21 Ability to Pay Guide​
FY21 Dental Rates
FY21 Non-chargeable List ​
​Glossary of Health Coverage and Medical Terms
Guidance on Billing Requirements
Guttmacher Institute Public Health Solutions - Confidentiality Review
HCPCS Codes Established for Coding the Levonorgestrel
Health Plans
HealthChoice DPP - Lifestyle Change Program
HealthChoice DPP FAQs - 4-15-20​
HealthChoice DPP Lifestyle Change Program
HealthChoice DPP Manual - Updated 4-24-20
HealthChoice DPP Manual Updated 4.24.20
HealthChoice: MCO Agreement - 2020
HealthChoice: MCO Comparison Chart - Revised February 28, 2020
HealthChoice: MCO Requirements - 2020
HealthChoice: Provider Brochure - August 2018​
Hep B Screen Medicare 2018​
Hepatitis C
Hepatitis C CPT Codes
Hepatitis C Sample Treatment Plan
HHS _ PHE EXTENSION 04 2021
HHS Launches New Reimbursement Program for COVID-19 Vaccine Administration Fees Not Covered by Insurance
HHS Title X 2019 Guidance: Frequently Asked Questions​
History of Present Illness and Review of Systems Guidelines
HIT Payer Coverage Billing Expansion COVID-19​​​​
HIV Coding Wall Poster
HIV-Specific ICD-10 Codes
​How Medicaid and VFC Work Together​
HP VFC Policy Change FAQs 2016​​
HP VFC Policy Change FAQs February 2016
HRSA COVID 19 CAF Program Fact Sheet
Hyperlinks to Forms
ICD-10 Palm Card - Updated 3-13-19
Immunet COVID-19 Vaccine Registration Order Guide
​Immunization (IZ) Services Billing Guide
Immunization Coding for OB-GYN 2019
Immunization CPT Codes Look-Up
Impact of the Title X Rule in Maryland
Important JHHC Provider Office Resources
Important Phone Numbers to Know - November 2019
Introduction and Background
​Introduction to Electronic Health Records (EHRs)
​IZ Admin Elsewhere in LHD
Jai Provider Manual 2021
JHHC - USFHP Low Back Pain Imaging Policy - Post Service Claim Review
JHHC Additional CPT Codes Requiring Preauthorization
JHHC Additional Place of Service Codes Allowed for USFHP Telemedicine Visits
JHHC Additional Security Measures for HealthLINK Access
JHHC Changes to Place of Service Codes for Telehealth Services
JHHC Corrected FAX Number - Additional CPT Codes Requiring Preauthorization
JHHC Correction Use of Long COVID-19 Code
JHHC COVID-19 Reimbursement Policy Update
JHHC COVID-19 Vaccination Registration through Immunet
JHHC Emergency Reimbursement Policy Set for COVID-19 Diagnostic Testing, Treatment, and Vaccination
JHHC eviCore Lab Management Program​​
JHHC Medical Records Request for HEDIS Measurement Year 2021
JHHC New CPT Codes Requiring Preauthorization Effective September
JHHC New Site-of-Service Preauthorization Requirements
JHHC On Demand Virtual Care Now Available for USFHP Members​​​​​
JHHC Priority Partners Guidance on the Continuation of Telehealth
JHHC Priority Partners Provider Manual 2021
JHHC Provider Notice ABA No Longer Covered as a Telehealth Visit for USFHP
JHHC Provider Notice ABA No Longer Covered as a Telehealth Visit for USFHP​​
JHHC Provider Pulse Newsletter Summer 2021
JHHC Provider Pulse Winter 2021
JHHC Provider Update Cigna PPO to Provide National Network for Johns Hopkins EHP​
JHHC Provider Update ICD 10 Codes to Identify SDoH​
JHHC Provider Update ICD-10 Codes to Identify Social Determinants of Health​​​​​
JHHC Reimbursement Policy Update
JHHC Reminder - Please Use Correct Address
JHHC Reminder of Utilization Management Processes in Light of Recent COVID Surge
JHHC Updated Addresses for Claims
Johns Hopkins/CareFirst Members Changed Plans Effective January 1, 2021
Kaiser HealthChoice Provider Manual Feb. 2020
Key Performance Indicators for Peak Financial Performance
LARC Quick Coding Guide - Contraceptive Implant and IUDs
LARC Quick Coding Quide-Contraceptive Implant and IUDs
Local Health Departments TB Control Coordinators Contact Information
MABHA Questions BHA Final Responses Updated March 14, 2020
Managed Care Organization (MCO) Agreement - 2020
Managing Your Revenue Cycle: What You Should Expect from Your Clearinghouse
Maryland Billing Appendix OPTUM BH2536 Final Revised
Maryland EPT Provider Guide​
Maryland Family Planning and Reproductive Health Program Administrative Guidelines - 2015
Maryland Family Planning and Reproductive Health Program Administrative Guidelines​ - 2015​​​
Maryland Health Care Commission: Reimbursement for Telehealth Services - March 2020
Maryland Health Connection Fact Sheet: Substance Use Disorder Treatment
Maryland HealthChoice MCOs Accreditation Status – Updated by NCQA as of September 16, 2019​
Maryland Healthy Kids Preventive Health Schedule
Maryland Healthy Kids Preventive Health Schedule​​
Maryland Healthy Smiles: Adult Dental Pilot Program Provider FAQs
Maryland Healthy Smiles: Provider Manual - Version 8.1
Maryland Insurance Request for Confidentiality - 2017
Maryland Local Health Department TB Program Phone Directory​​
Maryland Medicaid
Maryland Medicaid Dental 2021 CDT Fee Schedule Updated 1.7.21
Maryland Medicaid Dental Fee Schedule and Procedure Codes (CDT)​
Maryland Medicaid Dental Fee Schedule and Procedure Codes (CDT) - Revised January 2020
Maryland Medicaid Reproductive Health Services Overview - September 2019
Maryland Medicaid Self-Referral Services
Maryland Medicaid Telehealth​ Dentistry Guidance - Effective March 5, 2020
Maryland Medicaid Telehealth June 2020 Update Hyperlinks
Maryland Medicaid Telehealth Program COVID-19 Update March 2020
Maryland Medicaid Telehealth Program FAQ Updated
Maryland Medicaid Telehealth Program Manual March 2020 Update
Maryland Medicaid: New Provider Enrollment Portal - ePREP March 2020
Maryland Medical Assistance Family Planning Program Card
Maryland Medical Assistance Program Professional Services Manual - Effective January 2020
Maryland Minor Consent Laws 10 26 12
Maryland Minor Consent Laws 10 26 12​
Maryland One Health Bulletin - September 25, 2015
Maryland Oral Health Resource Guide - 2020 Edition
Maryland Oral Health Resource Guide 2020 2021 Edition
Maryland State Family Planning Title X Program Review Tool
Maryland Title X Facts 2020-3 MD
Maryland Title X Family Planning and Reproductive Health Program Information - 2017
MCO Notification of Denials to Patients - 2018
MCP Newsletters
MD Charges for Enhanced Infection Control and Personal Protective Equipment
MD Medicaid Fee Schedule 2020 Updates 11.1.20
MD Medicaid Professional Services Provider Manual - 2019
MD Medicaid UBH Claims Guide
MD Physician Care 2021 Provider Manual​​
MDH 2020 Certification Licensure for Behavioral Health-SUD Providers
MDH Behavioral Health Memo: Drug Testing Payment Charges - January 2018
MDH BHA Guidance Regarding Telehealth Expansion Regulations COVID-19 March 2020
MDH BHA Recovery and Wellness Support Resources for the COVID-19 Outbreak
​MDH BHA Telehealth Post Emergency Revised 7.16.21​​​​​​​​​​
MDH BHA Telehealth Post Emergency Revision 7.16.21​​​
MDH Coding Guidelines for Screening Tools for Primary Care​​​​​​​​​​​
MDH Coding Guidelines for Screening Tools for Primary Care - Final
MDH COVID FAQ Telehealth 9.22.20
MDH Guidance on Well-Child Visits and Preventive Care During the COVID-19 State of Emergency
MDH Managed Care Organization (MCO) Notification of Denials to Patients - 2018
MDH Memo COVID-19 #16: DDA Waivers Programs Telehealth and Telephonic Guidance April 2020
MDH Memo May 22, 2020 Lab Codes
MDH Memo Reconciliation and Recoupment BHASO Update
MDH Memo: Prior Authorization Changes Under the Maryland Contraceptive Equity Act Effective January 1, 2018
MDH Memo: Provider Information Required on MA Claims
MDH Protocols - Health Officers to Obtain the Secretary's Signature - 2014
MDH Public Health Emergency Extension October 7, 2020
MDH Telehealth FAQs May 26, 2020
MDH: Adult Dental Pilot Program
MDH: Adult Dental Pilot Program Overview​
MDMA Amerigroup Provider Newsletter November 2020
MDPP CMS Billing and Payment FAQs
MDPP Expanded Model PHE Flexibilities 3.30.2020​
MDPP Resources MLN 9.24.2020
Medicaid Amerigroup Provider Newsletter December 2020​
Medicaid Credentialing ePrep
Medicaid Hepatitis C Therapy Prior Authorization Form
Medicaid Hepatitis C Therapy Prior Authorization Form​
Medicaid Program Updates - Spring 2016​
Medicaid Provider Guidance COVID-19 Secretary's Orders Changes
Medical Billing Software​
Medical Policy Update Bulletin February 2021
Medical Record Documentation Standards - 2017​
Medicare 99211 Checklist
Medicare Advantage Provider Quick Reference Guide - 2020
Medicare Advantage: Health Care Professional Provider Manual - 2020
Medicare Billing for COVID-19 Vaccine Shot Administration
Medicare Claim Processing Manual
Medicare Claim Processing Manual - July 2019
Medicare Claims Processing Manual - Completing and Processing Form CMS-1500
Medicare Claims Processing Manual - Preventive & Screening Services June 2018
Medicare Claims Processing Manual Update 10.19.2020
Medicare CMS Billing Form 7.2019
Medicare Coverage: Parts B & D
Medicare COVID-19 Telehealth FAQs
Medicare COVID-19 Vaccine Shot Payment
Medicare Enrollment and Claim Submission Guidelines
Medicare ICD-10 Updates October 2020
Medicare ID Card Guide - 2020
Medicare Immunization Factsheet
Medicare New 2019 Waived CLIA Tests
Medicare New CLIA Waived Tests MM12204
Medicare Part B Immunization Billing​
Medicare Part D Vaccines and Vaccine Administration​
Medicare PHE Modifier Chart
Medicare Provider Enrollment
Medicare Remittance Advice Resources and FAQs
Medicare Roster Billing for Mass Immunizers
Medicare Telemedicine Health Care Provider Fact Sheet
Medicare Vaccine Coverage Part B vs. Part D
Medicare Vision Services Fact Sheet Updated​​​​​
Medicare Wellness Visits ICN MLN6775421
Medstar MCO Provider Manual 2021
Member Handbook - July 2017
Member ID Card
Member ID Card Digital Tool - 2020
Member Identification Card Quick Reference Guide
Memo Maryland Medicaid IEP/IFSP Telehealth Clarification Guidance April 2020​
Memo: Community Based Public Behavioral Health Providers 2% Rate Increase and Medicaid Program Updates for Spring 2016
Memo: Community-Based Medical Laboratory Billing for Substance Use Disorder Screening /Testing for Calendar Year 2017
Memo: Credentialing and Claims Reminder for Physician Assistants and Nurse Practitioner​ - 2019
Memo: Drug Testing Payment Charges
Memo: Medicaid Billing for Drug Testing and Screening - January 2017
Memo: Payment for Presumptive and Definitive Urine Drug Testing - April 22, 2019
Memo: Primary Care Fee Increase and Changes to Billing Codes for Vaccines for Children Administration (VFC) on January 1, 2013
Memo: Public Behavioral Health System Administrative Service Organization Vendor Change - September 2019​
Memo: Reprocessing Plan for Outstanding Psychiatric Rehabilitation Program (PRP) Reconciliation
MLN 2019-2020 Influenza Resources for Health Care Professionals
MLN Booklet: Behavioral Health Integration Services - Final 2019
MLN Booklet: Dual Eligible Beneficiaries Under Medicare and Medicaid
MLN Booklet: Medicare Mental Health​
MLN Booklet: Medicare Mental Health - January 2020
MLN COVID-19 Lab Fee and Charge Payment Update July 8, 2020
MLN COVID-19 Medicare FFS Update July 30, 2020
MLN Fact Sheet: Behavioral Health Integration Services
MLN Matters SE1013
MLN Matters SE18001: Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing
MLN Matters SE19022: 2019-2020 Influenza (Flu) Resources for Health Care Professionals ​
MLN Matters: Screening for Hepatitis C Virus in Adults​
MLN New Modification of POS Codes for Telehealth
Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service​
MPC Newsletter: Spring 2020​
NASTAD Issue Brief: Billing and Reimbursement
National Family Practice Title X Confidential and Covered
NDC Crosswalk Sample 2021
NDC Crosswalk Tables
New Codes for Laboratory Tests for COVID-19
New COVID-19 CPT Codes 2020
New COVID-19 CPT Codes 2020​​
New Medicare Card Information - April 2018
NFRHA Online Training Tool
NFRHA Superbill Example​​
Nongentital Infections Testing - NAAT Code Guide FINAL for STD TAC Website Posting 11.1.16
Novartis E&M Audit Guide - September 2014
Novitas Medicare Part B Website
Novitas Solutions e-News - January 2019
Novitasphere New User Checklist
NUCC 1500 Claim Form Instruction Manual
NUCC 1500 Claim Form Instruction Manual​​​
NUCC Claim Manual - July 2019
Nutrition and Diabetes Prevention Programs
Nutrition and Diabetes Prevention Programs​
Nutrition and Diabetes Prevention Programs​​
Nutrition Program​
​Office Ally Clearinghouse
Office Ally: Online Claims Entry Instructions​
Office Ally: Service Center User Manual
Office of Inspector General: Waiving of Co-Pays and Co-Insurance
OIG Waiving Copays
OP A Title X: National Family Planning Program
OPA ​Program Requirements for Title X Funded Family Planning Projects
​OPTUM 99072 Code Use
OPTUM 99072 Code Use
​OPTUM April 2022 Monthly Update from BHA
OPTUM ARP Rate Increase New Fee Schedules
OPTUM ARPA PBHS Rate Increases
OPTUM Authorization Alert Update - Medication Management 9.1.2020
Optum Authorization to Disclose SUD Treatment Information for Coordination of Care
OPTUM Auto Updating of Expired Licenses
OPTUM Backdated Authorizations
OPTUM Bed Hold Authorization Plans 1.5.22
OPTUM Bed Hold Process Guidance - RCS RRP
OPTUM BH FAQ COVID-19
OPTUM BH Monthly Partner Letter March 2022
OPTUM BHA and MDH Tobacco Control Survey 11.24.21
OPTUM BHA SOR Spring 2022 Newsletter
OPTUM Change Index OPTUM National Network Manual
OPTUM Changes to CARC Codes
Optum Claims Guide
OPTUM COVID Fact Sheet Recovery and Wellness Support
OPTUM COVID Fact Sheet Recovery and Wellness Support (6)
OPTUM EDIT PS Web EVS - Medicaid Provider
OPTUM EDIT PS Web EVS Medicaid Provider
OPTUM EDIT PS Web EVS Medicaid Provider​
OPTUM Extension for Authorization Entry
OPTUM Fee Schedule Update
OPTUM Funding for SAMHSA
OPTUM Funding for SAMSHA
OPTUM ICD-10 Diagnosis List Revisions
OPTUM ID name changing to Healthcare ID
OPTUM Incedo Provider Portal Auth Issues 3.31.22
OPTUM Incedo Provider Portal Quick Reference Guide
OPTUM Incedo Quick Reference Guide​
OPTUM March 2021 BHA Letter from Deputy Secretary
​OPTUM Maryland Billing Appendix BH2536 Final Revised 5.8.20
OPTUM Maryland Billing Appendix BH2536 Final Revised 5.8.20
OPTUM Maryland PBHS LOC Appendix BH2555 FINAL
OPTUM Maryland PBHS LOC Appendix BH2555 FINAL​​
Optum Maryland PBHS Provider Billing Appendix - Revised 5-8-2020
Optum Maryland Provider Alert: Critical Information for Launch - December 31, 2019
OPTUM Maryland Provider Manual Product Implementations BH2535 - Final Revised 02.05.20
OPTUM Maryland Public Behavioral Health System (PBHS) Level of Care Appendix​
Optum Maryland Public Behavioral Health System (PBHS) Level of Care Appendix
OPTUM MD BH Claims Quick Reference Guide
OPTUM National Network Manual
OPTUM Network Notes Newsletter Fall 2020
OPTUM New Authorization Plans Provider Alert 9.1.2020
OPTUM New Excecutive Order for Congregate and Residential Programs​
OPTUM New Executive Order for Congregate and Residential Programs​​​
OPTUM PBHS Provider Manual January 2020
OPTUM PBHS Provider Manual January 2020​​​
OPTUM Provider Alert - Individual Provider License Expiration
OPTUM Provider Alert 10.19.2020
OPTUM Provider Alert 12.9.2020
OPTUM Provider Alert Adding Codes Omitted from Auth Request
OPTUM Provider Alert Changes to Submitting Authorization Correction Requests
OPTUM Provider Alert Guidance on the Continuation of Telehealth for ABA Services
OPTUM Provider Alert Individual Provider License Expiration
OPTUM Provider Alert Payable Provider Types and Services in the ER
OPTUM Provider Alert SUD Residential Treatment Notice
OPTUM Provider Alert SUD Residential Treatment Notice​​​
OPTUM Provider Alert Updated Fee Schedule
OPTUM Provider Alert Updated Guidance for PRP RRP Referrals August 2021
Optum Provider Alert: Optum as New Behavioral Health ASO for Maryland - November 15, 2019
Optum Provider Alert: Optum as New Behavioral Health ASO for Maryland - November 15, 2019​
Optum Provider Alert: Release of Information (ROI) - November 6, 2019
OPTUM Provider Portal Quick Reference Guide Incedo​
OPTUM Psych Medical Necessity Alert 3.1.2021
OPTUM Psychological Testing Authority
OPTUM Psychological Testing Authorization
Optum Quick Reference Guide - December 5, 2019
​OPTUM Reconciliation Provider Alert Memo 7.21.2020
OPTUM Reconciliation Survey Provider Alert 7.23.2020
OPTUM Recoupment of Retro-Eligibility and Overpayments
OPTUM Recoupment Sequence 11.17.21
OPTUM Recroupment of Retro-Eligibility and Overpayments
OPTUM Remaining Authorization Units Feature in Incedo Provider Portal
OPTUM Remaining Authorization Units Feature in Incedo Provider Portal​​​​​​​​​​​​
OPTUM Residential Eating Disorder Program for Adults and Adolescents​
OPTUM Residential Eating Disorder Program for Adults and Adolescents​​​​​​​​​
OPTUM Staggering of PRP Authorizations
​OPTUM SUD Authorization Parameters Update
OPTUM SUD Authorization Parameters Update​​​​​
OPTUM SUD IOP Alert 3.19.2021
OPTUM Telehealth Updates Correction July 16 2021​
OPTUM Telehealth Updates Correction July 16, 2021​​​​​
OPTUM Timely Filing Waiver
OPTUM Uninsured Eligibility Alert 2.26.2021
OPTUM Uninsured Eligibilty Alert 2.26.21
OPTUM Update to Clinical Request Forms
OPTUM Updates to Clinical Request Form
OPTUM Updates to TCM Forms 10.30.20
OPTUM Updates to TCM Forms 10.30.20
OPTUM Use of UA Modifier
OPTUM Use of UA Modifier 10.22.2020
OPTUM Use of UA Modifier 10.22.2020​
OPTUM Vaccine Administration Information Form
OPTUM Vaccine Administration Information Form​​
OPTUM Waived Cost Sharing Updated
OPTUM Waived Cost Sharing Updated​​​​​​​​
OPTUM_ ARP Rate Increase New Fee Schedule Nov. 1 2021​
Outsource Billing Considerations
Participating Provider Quick Reference Guide
​Patient Portal Key Features
Patient Portals Benefits and Key Features
​​​Payer Portals - 2019​​​
​Payer-Provider Portals
Payor - Provider Portals
PECOS
PECOS CMS Website - Provider Enrollment and Certificate
PECOS Medicare Log-In Page
​Pediatric Coding - Commonly Administered Pediatric Vaccines
Pediatric Coding - Commonly Administered Pediatric Vaccines
Pediatric Coding Table - Commonly Administered Pediatric Vaccines
Pediatric Coding Table - Commonly Administered Pediatric Vaccines 8-2019
Pediatric Influenza Vaccine List
Pediatric influenza Vaccine List - 2019-2020
Pediatric/VFC Vaccine NDC List
Pediatric/VFC Vaccine NDC List 2019
Physician Credentialing and Recredentialing​ FAQs​
​Policies and Procedures​
Practice Management System Key Features and Functionality Requirements
Practice Mate(TM) - Free Practice Management Software​
Practitioner Credentialing Application - October 2016
Practitioner Office Site Evaluation Form - June 5, 2012
Precertification Request for Authorization of Services
PrEP 101 Consumer Information
PrEP Flow Chart
PrEP Guidelines
Priority Partners EOB Notice April 2018
Priority Partners Member Incentive for Completing COVID-19 Vaccination
Priority Partners Member Incentive for Completing COVID-19 Vaccination​​
Products and Benefits Guide - 2020
Professional Provider Relations Representatives
Provider Administrative Guide - 2020
Provider Agreement Signed
Provider Alert: Opioid DUR Provider Policy Ed Letter 6 23 17
Provider Alert: Two Percent Rate Increase for Community Based Behavioral Health Providers 6 26 17​
Provider and Facility Participation Criteria - 2019
Provider Data Exchange Form
Provider Handbook - 2020
Provider Link List
Provider Manual - 2019
Provider Manual - 2020​
Provider Manual - February 2020
Provider Manual - May 2020
Provider Manual - May 2020
Provider Manual Links
Provider Newsletter - December 2019
Provider Portal User Guide: Remittance/Notice of Payment
Provider Quick Reference Guide
Provider Quick Reference Guide - 2020
Public Health Emergency Extension Notice July 24, 2020
Public Mental Health System Rates
Public Mental Health System Rates - Effective July 1, 2018
Quick Guide to Cigna ID Cards - 2020
Quick Reference Guide - 2019
Quick Reference Guide - 2019-2020
Quick Reference Guide - 2020
Quick Reference Guide for Health Care Professionals - May 2020
Rabies COMAR Regulations​​
Refugee Services Coding Guide
Reimbursement for Lab Tests Performed in the Clinic
Reimbursement for SBIRT Services
Reproductive Health Title X Compliance Resources
Request for Confidential Communications Form
Request for Reimbursement for Non-Medicaid Services
Revenue Cycle Management
Revenue Cycle Management - Billing Office
Revenue Cycle Management - Clinical
Revenue Cycle Management - Front-End Processes
Revenue Cycle Management - Key Performance Indicators (KPIs)
Revenue Cycle Management Process
Revised Rates and Regulations for HIV Targeted Case Management
Ryan White Dental Facts - 2016
Ryan White Dental Facts 2016 2021
Ryan White Eligibility
Ryan White Funded HIV/AIDS Services Program
Ryan White HIV/AIDS Program Legislation - HIV/AIDS Bureau 2016​
Ryan​ White Legislation - Title XXVI HIV Health Care Services Program
Ryan White Program Admin Facts
Ryan White Program Admin Facts - 2016
Ryan White Program Overview Facts
Ryan White Program Overview Facts - 2016
SAMHSA: Coding for Screening and Brief Intervention Reimbursement
Sample Financial Hardship Policy
Sample Medical Practice Internal Control Work Program
Sample Paper Claim Form 2012
Sample Title X Grantee Compliance Plan for 2019 Title X Regulations
Sanofi Pasteur Product Coding​
Sanofi Pasteur Product Coding 2019-2010
SBHC Contact List - FY 2020
SBHC LEAHP Telehealth Schools Webinar Shifting Policy Practice Landscape 6.11.2020
​SBHC Medicaid Billing Review 9.14.2020
SBHC Provider Manual
SBHC Sample Superbill - 2017
SBHC Visit Report Form
SBIRT Brochure
SBIRT Fact Sheet
SBIRT Factsheet Medicare March 2020​​​​​
SBIRT Poster
SBIRT Press Release April 2016
SBIRT SAMHSA January 2020
School-Based Health Center (SBHC) Provider Manual - November 1, 2019
School-Based Health Center (SBHC): Provider Manual - November 1, 2019
School-Based Health Center Provider Manual​
School-Based Health Center Telehealth Checklist - FY 2020
Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs
Section I. Maryland General Information​
Section II. Creating the Billing Foundation​
Section III. Revenue Cycle Management​
Section IV. LHD Programs and Services​
Section IX. Resources​
Section V. Billing Related Software​
Section V. Billing Related Software
Section VI. Maryland Payors
Section VI. Maryland Payors​
Section VII. Contracting and Credentialing
Section VII. Contracting and Credentialing​
Section VIII. Compliance
Section VIII. Compliance​
Section X. Archive​
Services and Procedures Requiring Prior Authorization - August 2018​
Setting the Stage: Policy and Funding Landscape Impacting Third-Party Billing for STD-related Services
Specialty Exam: General Multi-System Template
​Standing Orders for Immunization
State/Local Agency Instructions: Using CCU's Access Database Template
​Statement of Disclaimer​
STI BH Counseling for Prevention USPSTF 8.2020
STI NCSD Billing Guide Oct. 2012
STI Sample Superbill
STI Tool​​​
STI, HIV and Family Planning Coding Guide - 3-2018
STI, HIV and Family Planning Coding Guide - 3-2018​
Strategy to Combat Opioid Abuse, Misuse, and Overdose
Submission of Claims Directly to Payer
Submitting Claims Directly to Maryland Medicaid: eClaim Overview
SUD FY2021 MD Medicaid Fee Schedule
SUD ICD-10 Changes Effective 10-1-16
SUD MD Medicaid Fee Schedule
Telehealth Center for Connected Health Policy Telehealth 2021 Billing Guide
Telehealth Center for Connected Health Policy Telehealth 2021 Billing Guide​​
Telehealth MDH COMAR 10.09.49 October 2019
Telehealth Payer Billing Guide Revised 12.1.2021
Telehealth Payer Billing Guide Revised 2021​​​
Telehealth Payer Billing Guide Revised 4.10.21
Telehealth Program Manual - Updated October 2019
Telehealth Services
Telehealth Services for the COVID-19 PHE Update April 2020
Telehealth SUD Intensive Outpatient Program (IOP) Guidance - 041520
Telemedicine - Medicare Changes January 1, 2020
Texas Billing and Coding Guide
Texas Billing and Coding Guide - 2014
Time Based Coding
​Title X 101 Fact Sheet​
Title X 101 Fall 2020
Title X Charges, Billing and Collections Guidelines
Title X Developing Sliding Fee Schedule FPNTC
Title X Fact Sheet
Title X Federal Register - March 2019
Title X Job Aid FPNTC Copay Job Aid ​
Title X Verifying Patient Income
Title X Wins Final
UHC Advanced Practice Health Care Provider Policy Professional - Reimbursement Policy​​
UHC Commercial Medical Policy Update Bulletin​​​​​​​​​​​
UHC Commercial Medical Policy Update Bulletin December 2021
UHC Commercial Reimbursement Policy Update Bulleting December 2021
UHC Commercial Reimbursement Update Bulletin
UHC Community Plan Medical Policy Update Bulletin
UHC Community Plan Telehealth and Telemedicine Policy​​​​​​​
UHC COVID 19 Provider Billing Guidance
UHC COVID Billing Updates March 2021
UHC COVID-19 Hyperlinks Updated June 19, 2020​
UHC COVID-19 Practice Admin Program July 2020
UHC COVID-19 Provider Billing Guidance June 15, 2020​
UHC COVID-19 Provider Billing Guidance Updated July 2021
UHC COVID-19 Provider Billing Guidance Updated July 2021​
UHC COVID-19 Temporary Cost Share Waiver
UHC COVID-19 Temporary Cost Share Waiver​​​​​​
UHC COVID-19 Temporary Provision Guidance
UHC COVID-19 Temporary Provision Guide​​​​​​
UHC COVID-19 Temporary Provision Guide 4.19.2021
UHC COVID-19 Temporary Provision Guide 7.20.2021
UHC COVID-19 Updates June 2020
UHC Dental Policy Update Bulletin January 2022​​​​​
UHC Digital Solutions Comparison Guide
UHC Medical Policy Update Commercial
​UHC Medicare Advantage Coverage Summary Update Bulletin December 2021
UHC Preventive Care Services 4.1.21
UHC Provider Claim Review Tool
UHC Provider Portal Overview​​
UHC Summary of COVID-19 Dates by Program
UHC Telehealth and Telemedicine Policy
UHC Telehealth Patient Scenarios 2021
UHC Telehealth Patient Scenarios 2021​
UHC Telehealth Patient Scenarios April 7, 2020
UHC Telehealth Service Preventive Medicine ABA Codes
UHC Telehealth Services Preventive Medicine ABA Codes
UHC/OPTUM ID Name Changing to One Healthcare ID
UMD Credentialing Appiication 2017
Understanding Features and Functions of an EHR
University of Maryland Health Partners Provider Manual 2021​
Using Standard Orders for Administering Vaccines: What You Should Know
Vaccine Administration Patients over 19 & Non-VFC
Vaccine Information Sheets - Required Use​
Vaccine Information Sheets - Required Use October 2019
Verifying Patient Income in a Title X Setting
VFC - CDC Info at a Glance
VFC Eligibility Criteria
​​VFC MA List - January 2019
VFC Patient Eligibility Screening Record - March 2015
VFC Policy Change Provider Letter - February 2016
VFC Provider Responsibility to Screen for VFC Patients
VFC SE Mod on CMS Claim
VID-19 Dental
Vivitrol Billing and Coding Guide
What is Medicaid and HealthChoice
​Women's Health Programs and Policies - April 2019
Women's Preventive Services Guidelines - 2016​​​​​​
WPSI - Well Woman Chart​​
​ WPSI - Well Woman Chart FAQs​​