MedicaidAdministrativeHigh impact
Enrolling Rendering Maryland Medicaid Providers
Maryland Medicaid·MD · Physical Therapy, Occupational Therapy, Speech Therapy·Provider Transmittal
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is activating a system edit effective January 1, 2021 that requires the NPI of individual/rendering providers (PT, OT, SLP) to be included in Box 24J on all claims. Claims submitted for dates of service on or after this date without an enrolled individual/rendering provider NPI will be denied. Some therapy groups will receive new Medicaid provider numbers by mail.
Action Required
By December 31, 2020: (1) Billing team must verify that all individual/rendering PT, OT, and SLP providers are enrolled with Maryland Medicaid using the Provider Verification System (PVS) at https://encrypt.emdhealthchoice.org/searchableProv/main.action. (2) Any unenrolled rendering providers must complete enrollment at eprep.health.maryland.gov before the effective date. (3) Update billing system configuration to require and validate the individual/rendering provider NPI in Box 24J for all PT, OT, and SLP claims with service dates on or after January 1, 2021. (4) Notify all therapy group providers, clinicians, and front-office staff of the requirement. (5) Monitor mail for notification of any new Medicaid provider numbers assigned to your therapy groups effective January 1, 2021 and update billing system accordingly. Failure to comply will result in claim denials for all PT, OT, and SLP services. Contact Stephanie Hood at (410)767-3998 or Stephanie.hood@maryland.gov with questions.