HPV Vaccine Now Covered for Adults Up to Age 45

Maryland Medicaid has officially updated its coverage policy to fully reimburse providers for administering the HPV vaccine (Gardasil 9) to eligible patients up to age 45. This significant policy change removes prior financial barriers and expands access to HPV-related cancer prevention for both adolescents and adults across the state.

What's Changed

Gardasil 9 is now fully covered for Maryland Medicaid and Medicaid MCO patients ages 9–45, with appropriate billing codes for reimbursement.

Key Points for Family Physicians

• Ages 9–26: ACIP recommends routine HPV vaccination
• Ages 27–45: ACIP recommends shared clinical decision-making (SCDM) to determine if vaccination is appropriate
• Billing: Use CPT code 90651 for the vaccine plus a separate administration code

Clinical Action:
Take advantage of this expanded coverage by:

• Strongly recommending HPV vaccination for all eligible patients ages 9–45
• Initiating SCDM discussions with adults ages 27–45
• Routinely assessing vaccination status and offering same-day vaccination when possible

For more information, physicians can reference the full coverage and billing guide (PDF).