Maryland Medicaid Billing
(including Medicaid Managed Care Providers in
Maryland)
The following documents are required to bill Maryland Medicaid. We are not able to bill any Medicaid program outside of Maryland.
All required items must be received prior to test initiation.
| Copy of patient's insurance or Medicaid card, front and back | |
| Letter of medical necessity from referring physician | |
| If 18 or older, copy of driver's license or photo ID | |
| Physician referral or prescription for testing | |
| Signed Advanced Beneficiary Notice Form |
Links to Forms
Advanced Beneficiary Notice
Sample letter of medical necessity
Checklist for creating a letter of medical necessity