MedicaidReimbursementHigh impact
Maryland Medicaid enhanced reimbursement rates for eligible primary care providers, effective August 1, 2025
CareFirst BlueCross BlueShield·MD · Family Medicine, Internal Medicine, General Practice +2 more·Reimbursement
Effective date
Aug 1, 2025
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has implemented enhanced reimbursement rates for eligible primary care providers effective August 1, 2025. The higher rates apply to evaluation and management codes 99202-99499 and G2211, with Managed Care Organizations required to pay these minimum rates to in-network PCPs.
Action Required
By August 1, 2025: Billing team must verify eligibility for enhanced Maryland Medicaid reimbursement rates by reviewing Physician Transmittal No. 176, Physician Assistant Transmittal No. 19, and/or Nurse Practitioner Transmittal No. 40 from Maryland Department of Health. Update billing system to reflect new fee schedule rates for E&M codes 99202-99499 and G2211 when billing Maryland Medicaid and MCOs. Verify provider designation as PCP with CareFirst CHPMD for enhanced rates.