Provider Information
APPLY AS A MEDICAID PROVIDER or RE-ENROLL AS A MEDICAID PROVIDER
Nursing Facility Assessment and Reimbursement Handbook 2-2010
Nursing Facility Assessment and Reimbursement Handbook 10-2010 for MDS 3.0
Maryland Monthly Assessment 10-2010 for MDS 3.0
MAPCSP FY 08 Rate Memorandum
1184 E-Medicaid New Born Processing Instructions, eff. April 2012
Eligibility Verification Systems (EVS)
Application systems available to providers to allow verification
of Maryland Medicaid recipient's eligibility status for Medicaid benefits.
DHMH has three EVS applications:
- IVR - Telephone inquiry/response system. Click here for the EVS IVR User Guide
- WebEVS - Web-based EVS application available for provider's with access to eMedicaid.
- 270/271 - HIPAA EDI transaction sets used for batch and real-time eligibility inquiry and response.
Hospice Services
Provider Relations Call Center
Time Limits - Submitting Invoices
Billing Instructions for Professional, Institutional and Dental Providers (revised April 2013)
Health Information Portability and Accountability Act (HIPAA)
Frequently Asked Questions List
Provider Transmittals
Drug Formularies
2013 Physicians Fee Schedule UPDATE (PDF VERSION)
2013 Physicians Fee Schedule UPDATE (XLS VERSION)
2013 Physicians Services Provider Fee Manual
Physician Forms for Abortion, Hysterectomy, Sterilization, and Preauthorization
Medical Laboratory Fees in Excell (2013).xls Updated May 17, 2013
Medical Laboratory Fees in Excell (2013).pdf Updated May 17, 2013
Dental Fee Schedule and Procedure Codes July, 2009
Dental Billing Instructions
EPSDT: Audiologist and Hearing Aid Dispenser Services (COMAR 10.09.51) Provider Manual
Vision Care Services Provider Fee Manual - May 2010
Vision Preauthorization Form
EPSDT Chiropractic, Speech Language Pathology, Occupational Therapy and Physical Therapy Provider Manual 6/7/10
Podiatry Services Provider Manual revised July 2009
OB/GYN Family Planning Services Provider Manual (Revised March 2012)
Provider Training
Freestanding Birth Center Facility Fee Schedule
Local Health Services Request Form
MMA Providers & Other Entities Sanctioned List - Updated May 15, 2013
MMA Providers & Other Entities Sanctioned List - Updated May 15, 2013
Maryland Healthy Kids Program
Medicare Advantage Plan Cost Sharing Memorandum
Medicare Advantage Plan Billing Instructions for UB04
Medicare Advantage Plan Billing Instructions for CMS-1500
Billing Instructions for ADAA Certified Addictions Outpatient Program Providers
Private Duty Nursing/Home Health Aide Fee Schedule - Eff. 11/1/08
Private Duty Nursing/Home Health Aide Fee Schedule - Eff. 07/01/11
Provider Guidance - Credible Allegation of Fraud and Payment Suspension
Credible-Allegation-of-Fraud-Ltr
CMS-Additional-Guidance-Credible-Allegation-of-Fraud