MedicaidBilling CodesMedium impact
PT 56-26: DME/DMS Fee Schedule Updates
Maryland Medicaid·MD · Endocrinology, Urology, Family Medicine +1 more·Coding
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
Maryland Medicaid updated DME/DMS fee schedules effective January 1, 2026, introducing new HCPCS codes A4295-A4297 for hydrophilic catheters and expanding continuous glucose monitor coverage to Type 2 diabetes patients requiring insulin. Providers must use the new catheter codes instead of A4351-A4353 for hydrophilic products and can bill updated rates for items furnished on or after January 1, 2026.
Action Required
Immediately: Billing team must update system to use new HCPCS codes A4295, A4296, and A4297 for hydrophilic catheters instead of A4351, A4352, and A4353. Download updated fee schedule from Division of Community Support Services website. Update encounter forms and staff training materials. Claims using old codes for hydrophilic catheters will be incorrectly processed.