MedicaidCoverageMedium impact
PT 08-26: Medicaid Coverage for Coronary Calcium Score Testing
Maryland Medicaid·MD · Cardiology, Family Medicine, Internal Medicine +1 more·Managed Care
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
Starting January 1, 2026, Maryland Medicaid (Fee for Service and HealthChoice) will expand coverage for coronary calcium score testing (CPT 75571) to align with American College of Cardiology guidelines. No prior authorization is required for this test under Fee for Service Medicaid.
Action Required
Before January 1, 2026: Billing team should verify that CPT 75571 (coronary calcium score testing) is set up for Maryland Medicaid billing without prior authorization requirements. Update billing system and encounter forms to reflect expanded coverage under American College of Cardiology guidelines for cardiovascular disease prevention.