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MedicaidAdministrativeHigh impact

Prescriber NPI Mandated on Pharmacy Claims

Maryland Medicaid·MD·Pharmacy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Maryland Medicaid now requires the prescribing provider's NPI (National Provider Identifier) to be included on all pharmacy claims for prescription drugs. This is a mandatory field that must be populated for claim processing.

Action Required

Action needed
Immediately: Billing team must ensure all pharmacy claims submitted to Maryland Medicaid include the prescribing provider's NPI number in the appropriate field. Update billing software to make prescriber NPI a required field for pharmacy claims. Coordinate with providers to ensure NPI information is captured at time of prescribing. Claims missing prescriber NPI will be rejected.

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