Maryland Medicaid Physician Fee Schedule 2026

Maryland Medicaid publishes 8 physician procedure rates effective 2026 on its fee-for-service schedule. This page shows published rates for common physician procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full Maryland physician schedule has 8 codes.

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Published codes

8

Physician procedures on the 2026 schedule

Median % of Medicare

--

no national Medicare comparator for this category

Effective vintage

2026

latest effective year on the schedule

Maryland's published Medicaid fee schedule covers durable medical equipment, prosthetics, orthotics, and supplies. Other service categories are paid through managed care and are not published as FFS rates.

Common physician procedures and what Maryland Medicaid pays

A curated sample of recognizable procedures from the 8-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.

CodeProcedureMaryland rate% of Medicare
99401Preventive counseling, 15 minutes$42.41--

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.

More Maryland Medicaid fee schedules

Physician rates in neighboring states

Frequently asked questions

What does Maryland Medicaid pay for physician and professional services?

Maryland Medicaid publishes 8 physician procedure rates effective 2026 on its fee-for-service schedule. The schedule covers office visits, preventive care, surgery, and evaluation and management services. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.

How do Maryland's physician rates compare with Medicare?

Most physician codes in this category have no direct national Medicare comparator (Medicare prices these services through different mechanisms), so a median comparison is not published here.

Do physician services need prior authorization in Maryland?

Maryland does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".

Where do these rates come from?

Directly from Maryland's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.

Get an email the next time Maryland changes these rates.