How Much Money Does Maryland State Medicaid Pay Doctors for a Breast Reduction?

i recently got approved for breast reduction by state medical asstisstanc , how much does medical assitance pay the doctor in the state of maryland?

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4 Doctor Answers | Asked by FOA in Columbia, MD

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Breast Reduction and Medicaid?

Thank you for the question and picture. Although you may be an excellent candidate for breast reduction surgery I think the biggest challenge you will have is finding a reputable plastic surgeon who works with Medicaid. Best wishes.

Breast Reduction - How Much Money Does Maryland State Medicaid Pay Doctors for a Breast Reduction?

Hi FOA, The real question is whether you can find a surgeon you're comfortable with who will accept whatever the payment is as payment in full for a breast reduction. A breast reduction is a reasonably long and complicated procedure. While it may not require the most sophisticated techniques (such as microsurgery) it takes many hours to perform, and there is the preoperative assessments and postoperative care to consider - all of which are included in what the payers refer... more

Medicaid Does Cover Breast Reduction

Maryland fee schedule for CPT 19318 (breast reduction) pays 834 for the first breast and 417 for the second. This includes before and after care for 90 days around the procedure and the procedure itself. It does not include anesthesia or hospital fees. Your doctor will most likely need to get the procedure pre-approved.

Medicaid fees are low.

If it is anything like Texas it would be about $800.00 which is not enough for the Doctor to justify the time to do the procedure. Even regular health insurance pays very little for procedures like this at around $1800.00. The time it takes to do the reduction and the follow up care is great and this level of compensation is ridiculous for the services provided.