MedicaidAdministrativeHigh impact
Enrolling Rendering Maryland Medicaid Providers – REVISED PROCEDURE
Maryland Medicaid·MD · Physical Therapy, Occupational Therapy, Speech Therapy·Provider Transmittal
Effective date
Mar 1, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is requiring all individual/rendering providers (PT, OT, SLP) to be enrolled and have their NPI included on claims submitted on or after March 1, 2021. Providers will keep their current Medicaid numbers; no new numbers will be assigned. Any claims submitted without the enrolled rendering provider's NPI will be denied.
Action Required
By February 28, 2021: (1) Billing team must verify that all individual/rendering PT, OT, and SLP providers are enrolled with Maryland Medicaid by visiting eprep.health.maryland.gov and checking enrollment status via the Provider Verification System at https://encrypt.emdhealthchoice.org/searchableProv/main.action. (2) Update billing software to require the NPI of the enrolled rendering provider on all Maryland Medicaid claims. (3) Notify all rendering providers to complete individual enrollment if not already enrolled; therapy groups must approve provider affiliations. (4) Update claim submission workflows and provider training to ensure rendering provider NPI is captured on encounter forms and submitted with every claim. Failure to include the enrolled rendering provider NPI will result in claim denials effective March 1, 2021. Contact Stephanie Hood at (410)767-3998 or Stephanie.hood@maryland.gov with questions.