MedicaidCoverageLow impact
PT 47-26: Lead Paint Risk Assessor Billing
Maryland Medicaid·MD · Pediatrics, Family Medicine·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 18, 2026
Summary
Maryland Medicaid lowered the blood lead level threshold for environmental lead investigations from 5μg/dL to 3.5μg/dL, effective October 1, 2025. Lead Paint Risk Assessor organizations can now bill code T1029 at $418.49 per dwelling for children under 21 with elevated blood lead levels. This policy supersedes previous guidance PT 16-20 from 2019.
Action Required
Maryland providers only: If your practice performs environmental lead investigations, enroll as Lead Paint Risk Assessor provider through ePREP using NPIs with taxonomies 247200000X and 251K00000X. Update billing system to use code T1029 ($418.49) for comprehensive environmental lead investigations for Medicaid children under 21 with blood lead levels ≥3.5μg/dL. Verify Medicaid eligibility before service delivery through eMedicaid system.