MedicaidAdministrativeMedium impact
Spring 2025 General Provider Updates
Maryland Medicaid·MD · Pediatrics, Psychiatry·General Provider
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is creating separate provider types for pediatric and psychiatric hospitals in Fall 2025, requiring hospitals providing both services to maintain two separate enrollments with different NPIs. The policy also reinforces the prohibition on billing Medicaid participants for covered services.
Action Required
Fall 2025: Hospitals providing both pediatric and psychiatric services must enroll as two separate provider types with unique NPIs - one for pediatric services (billed through Fee-For-Service) and one for psychiatric services (billed through BHASO Vendor Carelon). Contact mdh.providerenrollment@maryland.gov for enrollment guidance. Ensure no Medicaid participants are ever billed for covered services to avoid sanctions including for-cause termination.