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Maryland

Maryland Behavioral Health Credentialing and Payer Enrollment

Maryland is replacing the portal you enroll through, and it froze applications on the way there. ePREP is being retired for MPRIME in October 2026. Program types closed on July 1, 2026. The individual clinician types, including nurse practitioner and APRN-PMH, are closed as of August 1, 2026. Anything filed during a hold comes back unprocessed. So the first question in Maryland isn’t which payers to chase. It’s whether your provider type can file at all today. These dates can move, so check them against the Maryland Department of Health before you plan a start date.

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Maryland payers and timelines

Why Maryland is different right now

The state’s calendar decides your Medicaid start date this year.

Two of these are timing and two are structure. Together they decide whether Maryland is a two-month build or a two-quarter one.

The 2026 enrollment freeze, by provider type

General Provider Transmittal No. 115, published January 29, 2026, and confirmed unchanged by No. 122 on June 18, 2026 verified July 27, 2026
  • Closed as of July 1, 2026: Outpatient Mental Health Clinic, Psychiatric Rehabilitation Services Facility, Mobile Treatment Program, Substance Use Disorder Program, Behavioral Health Crisis Stabilization Center
  • Closed as of August 1, 2026: nurse practitioner (CRNP), APRN-PMH, physician, psychologist, LCSW-C, the counselor group covering LCPC, LCMFT, LCADC and LC-PAT, and the ordering, referring and prescribing type
  • The hold covers new enrollments, revalidations and any change to an existing account, and Maryland says applications submitted during a hold are returned without processing
  • File in MPRIME by December 31, 2026 and Maryland says a new enrollment is eligible for a start date backdated to the later of your hold date or your license issuance date. Maryland also says backdates are not assured
  • There is a limited emergency exception for cases where waiting would affect patient health or safety, requested through the MPRIME mailbox with your NPI, provider type and service address
  • Maryland runs a dedicated MPRIME mailbox and keeps publishing updates. Dates can move, so confirm before you file

Revalidations were pulled forward

General Provider Transmittal No. 116, February 23, 2026
  • Anyone scheduled to revalidate between July 1, 2026 and the October go-live had it rescheduled earlier, with notices issued on a rolling basis from February through April 2026
  • You get 90 days from the notice, and Maryland says providers who don’t revalidate in that window may be suspended
  • The trigger is a letter, which makes the address on your enrollment load-bearing. When Carelon took over the behavioral health contract it mailed initial provider payments as paper checks to the address on file in ePREP
  • If you moved and never updated it, you have two problems and you only know about one of them

Behavioral health is carved out of the MCOs entirely

The Public Behavioral Health System
  • Specialty mental health and substance use services are carved out of the HealthChoice benefit package and administered statewide, fee-for-service, by one administrative services organization
  • Carelon Behavioral Health of Maryland has held that role since January 1, 2025, replacing Optum Maryland. Any instruction naming Optum Maryland is out of date
  • For a prescriber that means two Medicaid steps, not nine MCO contracts. Enroll with Maryland Medicaid, then register with Carelon
  • The state sets the service rules, the rates and the authorization standards. The vendor administers and pays

Separate door: Carelon, through ProviderConnect inside Availity Essentials

Back pay reaches groups, not solo practices

Md. Code, Insurance 15-112(w)
  • A carrier has to pay a participating group practice at the participating rate for services delivered by a clinician who isn’t credentialed yet
  • Conditions: employed by or a member of that group, application filed, the carrier’s notice of intent to continue processing received, a valid Maryland licence, and the hospital-credentialing or liability-insurance condition met
  • Payment runs from the date of that notice through the date the final decision is sent
  • A solo practice building its first panels gets nothing here. Which package fits you turns partly on that one fact

Where the delays actually happen

Getting on a panel isn’t the same as getting paid.

Most of the waiting happens in the gaps between these five steps. We work all of them, and we tell you which one you’re actually sitting in.

Credentialed›contracted›loaded›connected›payable

Two tracks

Medicaid is on the state’s calendar. Commercial isn’t.

That’s the sequencing decision in Maryland this year. Commercial work can start today whatever the portal is doing, so we run it while the Medicaid side waits for its window.

Maryland Medicaid

Enroll with the state, register with Carelon, stop.

More than 85 percent of Maryland Medicaid participants sit in HealthChoice, the mandatory managed care program, where nine MCOs cover physical health, pharmacy and the primary behavioral health a PCP delivers. Specialty mental health and substance use care is carved out of that benefit package and paid fee-for-service by the statewide administrator. So for a psychiatrist, a PMHNP or a therapist, the Medicaid payer is usually the Public Behavioral Health System, not the plan on the member’s card.

How you enrollIn ePREP under the provider type that matches how you bill, signing the Maryland ePREP Provider Agreement and whichever addenda your provider type requires. Maryland assigns your MA number when the application is approved and processed. Carelon is direct about the order: you may not render behavioral health services under the state system until you’re enrolled in Maryland Medicaid.
Then CarelonRegister with the Provider Digital Front Door, which is ProviderConnect reached through the Maryland Public Behavioral Health System space in Availity Essentials. That’s where authorizations and claims work happens. Groups use an Account Request Form to put everyone under one account, and Carelon requires a group to include at least one independently licensed provider who is enrolled in Medicaid.
Forms you’ll actually see

Maryland ePREP Provider AgreementProvider-type addendaORP enrollment, type 92Carelon Account Request Form

One NPI is rarely enoughMaryland requires a separate NPI and MA number for each approved or licensed service, and for the same service at more than one location. A practice running an outpatient mental health clinic, a psychiatric rehabilitation program and an opioid treatment program at one address needs three sets. Three separately licensed clinics in three towns need three more. Tell us every program and every address up front.
Two hard edgesCarelon says the effective date of your account is the date the completed application was processed, and that providers are at financial risk for services delivered before their MA number is active and for services the administrator hasn’t authorized. Nothing backdates that. Local behavioral health authorities, the local systems managers formerly called Core Service Agencies, handle local coordination and some grant-funded work. They are not the payer, and it’s easy to mistake one for the other.

Commercial

Maryland tells carriers which form to accept, and it’s CAQH.

CareFirst is the contract that does the most work here. It’s the largest carrier in the region and its network covers Maryland, Washington DC and Northern Virginia, which is one metro market rather than three states of paperwork. Under Insurance 15-112(g)(3) a carrier has 30 days after a completed application to send written notice that it’s continuing to process or rejecting you, then 120 days from that notice to decide and notify you in writing.

Your CAQH stays yoursYou complete and attest your own profile. We’re added as an authorized practice manager, so we keep the practice data current and get each payer authorized. We never ask for your password. Under Insurance 15-112.1 the Commissioner designates a uniform credentialing form and carriers must accept it as the sole application, and the Maryland Insurance Administration designated CAQH in Bulletin 09-25. Re-attest every 120 days.
Behavioral health has its own doorOptum for UnitedHealthcare, started in Provider Express. Evernorth for Cigna. A separate behavioral health request for participation at Aetna. In house at CareFirst, which ended its Magellan Healthcare arrangement on April 1, 2018, and in house at Johns Hopkins Health Plans and Kaiser Permanente. Applying at the medical door where a carve-out vendor runs the network is the most expensive routine mistake here.
A CareFirst rule to settle before you applyCareFirst requires everyone in the same practice to participate in the same networks, so BlueChoice and Regional Preferred is a practice-level decision rather than a clinician-by-clinician one. It also uses CAQH as its credentialing verification organization and doesn’t accept paper, wants directory information confirmed every 90 days, and recredentials every three years.
Already on the calendarSenate Bill 808 of 2026, signed as Chapter 706, takes effect January 1, 2027. It eliminates application fees for providers applying to carrier panels, tightens carrier notice requirements with civil penalties attached, requires carriers to keep directories current, and changes which credentialing applications the Commissioner may designate. We re-verify against the final regulations before it lands.
Seeing patients in DC or VirginiaOne CareFirst contract reaches Blue members who live elsewhere through BlueCard, and Aetna, Cigna with Evernorth, and UnitedHealthcare with Optum are national. The gate is a licence where the patient is sitting. Say at intake if you hold a DC or Virginia licence, because in this market that changes which single contract covers your whole panel.

Maryland commercial payers

Who you’ll apply to, and how long it usually takes.

These are typical ranges from a complete application, inside Maryland’s 30-day notice and 120-day decision clock. Payers control their own timelines, so we track them rather than promise them.

CareFirst BlueCross BlueShield

BlueChoice, Regional Preferred, the state employee plans, and the whole DC metro
  • Usually: 60 to 120 days from a complete file, with the statutory 30-day notice and 120-day decision sitting behind it. Recredentialing every three years
  • How it goes in: a CAQH profile with CareFirst authorized, plus the CareFirst questionnaire that matches your provider type. No paper. Group requests also want the tax ID, W-9 and a practitioner roster with NPIs, licences and insurance
  • Behavioral health: managed in house since April 1, 2018, when CareFirst ended the Magellan Healthcare arrangement. Authorizations run through the CareFirst provider portal
  • Watch: everyone in the practice has to be in the same networks, so decide BlueChoice and Regional Preferred before anyone applies

UnitedHealthcare and Optum

The clearest open door in the state
  • Usually: 60 to 120 days from a complete application, started inside Provider Express with Join Our Network. Separate from core UnitedHealthcare medical
  • Why it’s a strong first application: Optum’s Maryland page says it recognises Maryland as an any willing provider state and lists prescribers as sought in all counties, along with telemental health, medication assisted treatment prescribers, child and adolescent specialists, and Express Access providers who can see someone within five business days
  • Watch: UnitedHealthcare Community Plan of Maryland is a separate contract from commercial and from Optum’s behavioral network

Separate door: Optum Behavioral Health

Aetna

Behavioral health in house, on its own form
  • Usually: a request for participation first, an answer on network need and eligibility within 45 days, then credentialing pulled from CAQH, then contracting. Commonly 60 to 120 days end to end. Recredentialing generally every 36 months
  • Path: behavioral health clinicians use Aetna’s separate behavioral health request for participation, even when joining a medical group. Starting on the medical form is a common way to lose three weeks
  • Watch: Aetna Better Health of Maryland is Medicaid and a different contract from commercial Aetna

Johns Hopkins Health Plans

One relationship, four lines of business
  • Usually: no published standard turnaround, and Maryland’s 30-day notice and 120-day decision clock applies to its commercial lines. Getting in the door starts with a Letter of Interest to Provider Relations rather than a portal application
  • How it goes in: CAQH with Johns Hopkins Health Plans authorized. The plan can send a CAQH invitation at no cost to a practitioner who isn’t a member yet
  • Why it matters: in the Baltimore corridor a meaningful share of employed patients carry Employer Health Programs. It also runs the US Family Health Plan, Advantage MD and Priority Partners
  • Watch: Priority Partners is the Medicaid line and a separate contract. Being loaded for one line is not being loaded for all four, so confirm exactly which lines your agreement names

Kaiser Permanente of the Mid-Atlantic States

Worth asking about, contrary to the usual assumption
  • Usually: no published turnaround, because the gate is network need rather than a queue. Confirm at the point they engage
  • Why it’s here: don’t carry over the assumption that Kaiser is closed to outside clinicians. The Mid-Atlantic region serves Maryland, DC, Northern Virginia and parts of West Virginia and runs a community provider network with its own portal, manual and behavioral health chapter, so contracted outside clinicians do see Kaiser members
  • Watch: claims run on a 180-day timely filing window, tighter than several carriers here

Cigna Healthcare and Evernorth

Paused right now, nationally
  • Right now: Evernorth paused new individual and clinic behavioral health applications on June 1, 2026 and has signalled a reopen after September 1. Facilities are exempt and anything filed before June 1 keeps processing
  • Usually: up to about 90 days to join the behavioral network once it’s open, with CAQH re-attestation every 120 days
  • What we do: we queue it and tell you the wait rather than putting a paused panel in your opening set

Separate door: Evernorth Behavioral Health

Two Maryland names changed and the old ones are still in circulation. Wellpoint Maryland is the plan formerly called Amerigroup Community Care, and CareFirst Community Health Plan Maryland was University of Maryland Health Partners, so older directories, contracts and billing guides name entities that have moved. On the behavioral health side, Optum Maryland has not run the Public Behavioral Health System since December 2024, and Magellan Healthcare has not run CareFirst behavioral health since April 2018. If a checklist names either one, it’s stale. Medicare, and Maryland Medicaid including the Carelon-administered behavioral health system and the HealthChoice MCOs, are scoped and priced separately from a commercial package.

Carry a plan we didn’t list? Add it.

The State of Maryland Employee and Retiree Health and Welfare Benefits Program is a large self-funded book administered by commercial carriers rather than a plan you contract with directly, and CareFirst is one of the administrators. You reach those members through the administering carrier’s network, which is a practical argument for holding CareFirst even when your commercial mix looks light on Blue. Local behavioral health authorities, the local systems managers formerly called Core Service Agencies, are not payers for routine outpatient Medicaid work, and we identify yours so a local approval doesn’t get mistaken for a payer contract or the other way around. Baltimore City doesn’t work like Montgomery County. And Maryland Taft-Hartley funds in the building trades and UFCW-affiliated world are usually reached by joining a rented commercial network rather than by contracting with the fund. You name the plan. We find the real route.

What we need from you

Send these once and we can start.

You give us this in one intake. Then we fill out the applications. No passwords, no patient information, and nothing gets submitted until you’ve read it and signed.

  • Whether you’re joining a group that already holds the contractThat one answer decides whether the interim payment rule under Insurance 15-112(w) can cover you while credentialing runs, or whether nothing does. It also decides which package fits.
  • Every program and every addressMaryland requires a separate NPI and MA number for each approved or licensed behavioral health service, and for the same service at more than one location. Tell us the full picture up front or we build the wrong enrollment.
  • Your individual NPIPlus the Type 2 if you bill under a group or entity, and the taxonomy attached to each.
  • Active Maryland licence and DEAAnd tell us if you also hold a DC or Virginia licence, because in this market that changes which single commercial contract covers your whole panel.
  • CAQH attested and authorizedYou attest it. We keep it current. In Maryland it carries statutory weight, because CAQH is the Commissioner-designated uniform credentialing form and CareFirst uses it as its verification organization and won’t take paper. Re-attest every 120 days.
  • Delegated access for the Medicaid workSo we can prepare your Maryland Medicaid enrollment and your Carelon ProviderConnect registration without anyone sharing a password. Plus the mailing address and email on your enrollment record, because that’s where revalidation notices go and where Carelon has mailed provider payments.
  • Five years of work historyMonth and year, with any gap over six months explained. This is the single most common reason a CAQH-driven file gets sent back.
  • Malpractice certificateThe current declarations page naming you. It’s also one of the conditions in the group-practice interim payment rule.
  • Entity name, EIN and W-9One per tax ID. CareFirst also asks for a practitioner roster with NPIs and licences on group requests.

Depending on what you plan to bill, Maryland may want the practice itself licensed as a behavioral health program, separately from your own licence. The state’s term is a community-based behavioral health program licence from the Behavioral Health Administration under COMAR Title 10, Subtitle 63, and several of those categories are accreditation-based. Two payer-side signals point at it: Carelon’s manual says behavioral health programs need to be accredited and licensed to qualify as a Medicaid provider while individual practitioners are covered by their own board, and Carelon’s own join-the-network instructions start with a Behavioral Health Administration licensure application before Medicaid enrollment. It’s a real fork in the road in Maryland, because it changes which Medicaid provider type you enroll under and which freeze date applies to you. A solo prescriber doing outpatient medication management is a different situation from a program. We check it with you during intake, before it can stall a payer contract. We don’t give legal advice and we don’t file it for you.

How it works

You answer once. We do the paperwork.

You can buy online without a meeting. Published price, published scope, no call needed unless you want one.

Buy the package

Published price and scope. No call needed.

One intake

Short and guided. It asks more only where your answers call for it, starting with your provider type and where it sits in the Maryland freeze schedule.

We prepare everything

The Medicaid enrollment, the Carelon registration and every commercial file, built from what you told us.

You review and sign

Read it, change anything, sign. Nothing goes out until you say so.

We submit and track

Every purchase includes Command Suite, so you can see where each payer application stands, what we’re working on, what’s waiting on a payer, and what we still need from you.

What we stand behind

Payer decisions, timing and rates are not ours to promise, and we don’t promise them. Our own work is a different matter. If something we delivered does not work the way we said it would, we fix it at no charge for 30 days after delivery, including one stabilization review. A new request, another payer or provider, a change of scope, or a new build is quoted separately. You won’t get an invoice for correcting our mistake.

Built to keep working after we’re done

Everything we set up is built for the practice you are growing into, not only the one you have today. Adding a provider or a second location should be a configuration change rather than a rebuild. When the engagement ends you own the accounts, the documentation and the systems, and they keep running without us. No lock-in.

Questions we get

Maryland credentialing questions

Can I still enroll with Maryland Medicaid right now?
It depends on your provider type and on today’s date, so check before you file. Maryland Medicaid is retiring ePREP for MPRIME in October 2026 and froze ePREP applications in phases on the way there, under General Provider Transmittal No. 115, published January 29, 2026. Program and facility types closed on July 1, 2026: Outpatient Mental Health Clinic, Psychiatric Rehabilitation Services Facility, Mobile Treatment Program, Substance Use Disorder Program and Behavioral Health Crisis Stabilization Center. The individual clinician types close on August 1, 2026: nurse practitioner, APRN-PMH, physician, psychologist, LCSW-C, the certified professional counselor group covering LCPC, LCMFT, LCADC and LC-PAT, and the ordering, referring and prescribing type. The freeze covers new enrollments, revalidations and any change to an existing account, and Maryland says applications submitted during a hold are returned without processing. These dates can move. Confirm the current status against the Maryland Department of Health before you plan a start date. We verified this on July 26, 2026.
What happens to ePREP when MPRIME goes live?
MPRIME, the Maryland Provider Registration and Information Management Enterprise, replaces ePREP in October 2026, with a training window Maryland has signalled for August and September 2026. Maryland set up a dedicated mailbox for MPRIME questions and says it will keep publishing updates. Two practical consequences. If your provider type still has an open window, filing before your risk tier’s date beats waiting on a lease or an EIN. If your window has closed, the honest plan is to finish CAQH and the commercial applications now and queue the Medicaid work for the go-live, rather than filing something that comes back unprocessed. One thing worth knowing before you write off the gap: Maryland says a provider who submits a complete, processable application in MPRIME by December 31, 2026 is eligible to have the enrollment date backdated to the later of their hold date or their license issuance date. Maryland also says backdates aren’t assured and that you can’t bill until the application is approved, so it’s a reason to file early once MPRIME opens, not a reason to see patients on spec. We tell you straight which of those two you’re in.
Do I have to contract with all nine HealthChoice MCOs?
For behavioral health, usually not. Maryland carves specialty mental health and substance use services out of the managed care benefit package entirely and administers them statewide, fee-for-service, through one administrative services organization. Carelon Behavioral Health of Maryland has held that role since January 1, 2025, replacing Optum Maryland. So for most prescribers the Medicaid path is two steps rather than nine: enroll with Maryland Medicaid, then register with Carelon through the Provider Digital Front Door, which is ProviderConnect reached inside the Maryland Public Behavioral Health System space in Availity Essentials. The nine HealthChoice MCOs matter only for services the MCOs actually cover. Any guide telling you to bill an MCO for specialty behavioral health is out of date, and so is any instruction naming Optum Maryland.
Will a Maryland carrier pay me while my credentialing is still pending?
Only through a group. Under Md. Code, Insurance 15-112(w) a carrier has to pay a participating group practice at the participating provider rate for covered services delivered by a clinician who isn’t credentialed yet, as long as that clinician is employed by or a member of the group, has applied, has received the carrier’s notice of intent to continue processing, holds a valid Maryland licence, and meets the hospital-credentialing or liability-insurance condition. Payment runs from the date of that intent-to-process notice through the date the final decision is sent. Read the practical version. If you’re joining a group that already holds the contract, Maryland law can keep the lights on while your file is pending. If you’re solo and building your first panels, that protection doesn’t reach you at all, which is a real argument for filing early rather than waiting for a start date.
Does Maryland make carriers accept the CAQH application?
Yes, and it’s unusual. Under Insurance 15-112.1 the Insurance Commissioner designates a uniform credentialing form, a carrier or its credentialing intermediary has to accept that form as the sole application for credentialing and recredentialing, the form has to be free to providers, and the Commissioner can fine a carrier that doesn’t comply. The Maryland Insurance Administration designated the CAQH form in Bulletin 09-25. So an unattested CAQH profile in Maryland isn’t housekeeping, it blocks every commercial application at once. One change is already on the calendar: Senate Bill 808 of 2026, signed as Chapter 706, takes effect January 1, 2027 and alters which credentialing applications the Commissioner may designate, alongside eliminating panel application fees and tightening carrier notice requirements.
Do I need a separate contract for patients in DC or Northern Virginia?
Usually not, because this is one metro market rather than three states of paperwork. CareFirst holds the Blue licence across Maryland, Washington DC and Northern Virginia, and Kaiser Permanente’s Mid-Atlantic region covers roughly the same footprint. National carriers work the same way: one Aetna, one Cigna and Evernorth, one UnitedHealthcare and Optum contract covers every state you’re licensed in. The gate to a patient in DC or Virginia is a licence where that patient is sitting, not a second payer contract. Tell us at intake if you hold more than one of the three licences, because it changes which single contract covers your whole panel. Medicaid is the genuine exception, and joining another state’s network is its own question again.
How long does a Maryland carrier have to decide?
Maryland sets an outer bound most states don’t. Under Insurance 15-112(g)(3) a carrier has 30 days after receiving a completed credentialing application to send written notice that it’s continuing to process the application or rejecting it, then 120 days from that notice to accept or reject you and send written notice of the decision. In practice a complete commercial file commonly runs 60 to 120 days. That first notice does double duty for anyone joining a group, because it’s what starts the interim payment right under 15-112(w). Keep it, and keep the date on it.
Where does a behavioral health application go at each Maryland carrier?
Split down the middle here. Optum for UnitedHealthcare, started inside Provider Express. Evernorth for Cigna, which paused new individual and clinic behavioral health applications on June 1, 2026 with a signalled reopen after September 1. A separate behavioral health request for participation at Aetna, not the medical form. CareFirst, Johns Hopkins Health Plans and Kaiser Permanente handle behavioral health inside the plan, and CareFirst specifically ended its Magellan Healthcare arrangement on April 1, 2018, so authorizations run through CareFirst’s own provider portal. On the Medicaid side the behavioral health door is Carelon, not the member’s MCO. Applying at the medical door where a carve-out vendor runs the network is the most expensive routine mistake in this state.

Keep reading

Related

Maryland PMHNP scope of practiceWhat Maryland allows you to do, separate from who pays you.
Washington DC credentialingDC law makes CAQH the single form every insurer has to accept.
Virginia credentialingA split Blue state, with CareFirst holding the Northern Virginia corner.
Pennsylvania credentialingMedicaid behavioral health is carved out county by county.
West Virginia credentialingFour Mountain Health Trust plans, and a statute that pays you during the wait.
Opening your own practiceEntity, identifiers, payers, EHR and billing setup.
Adding a provider to your clinicFirst-time credentialing into contracts you already hold, which is the case Maryland’s interim payment rule was written for.
Changing your entity or tax IDMoving panels without breaking the money.

Ready to get billable in Maryland?

Start the intake and we’ll tell you where your provider type sits in the MPRIME schedule, then run the commercial set while the Medicaid side waits for its window. Most people never need a call.

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Where this comes from

  • Maryland Department of Health, Maryland Medicaid provider enrollment and the announced MPRIME transition verified July 26, 2026
  • Maryland Department of Health, Office of Medicaid Provider Services, General Provider Transmittal No. 115 (PT 59-26, January 29, 2026), the phased ePREP hold and the provider-type lists verified July 26, 2026
  • Maryland Department of Health, Office of Medicaid Provider Services, General Provider Transmittal No. 116 (PT 65-26, February 23, 2026), the MPRIME FAQ, early revalidation notices and the 90-day window verified July 26, 2026
  • Maryland Department of Health, Office of Medicaid Provider Services, General Provider Transmittal No. 122 (PT 94-26, June 18, 2026), the confirmed hold dates, the backdated enrollment window and the emergency exception, and No. 124 (PT 04-27, July 12, 2026), MPRIME training and the October go-live verified July 27, 2026
  • Carelon Behavioral Health of Maryland, join the network and the Public Behavioral Health System provider manual: enrollment order, ProviderConnect, the Account Request Form, and the separate NPI and MA number per service and location verified July 26, 2026
  • Maryland Department of Health, Behavioral Health Administration, Carelon assuming the behavioral health administrator role on January 1, 2025 verified July 26, 2026
  • Maryland General Assembly, Md. Code Insurance 15-112: the 30-day notice, the 120-day decision, and the 15-112(w) group-practice participating-rate rule verified July 26, 2026
  • Maryland General Assembly, Md. Code Insurance 15-112.1, and Maryland Insurance Administration Bulletin 09-25 designating the CAQH form verified July 26, 2026
  • CareFirst BlueCross BlueShield, professional credentialing overview, and the April 1, 2018 notice bringing behavioral health in house verified July 26, 2026
  • Optum Provider Express, Maryland any willing provider recognition and prescriber need in all counties verified July 26, 2026

Written by Ryan Berg, founder of AdvanceAPractice. 16 years in healthcare revenue cycle and credentialing.

Facts on this page were verified July 26, 2026 and are next due for review September 28, 2026.

Payer programs, plans and timelines change, and Maryland is moving faster than most states this year. Everything here carries a verification date and gets re-checked on a review cycle; this record is next due for review on September 28, 2026. Approval and effective dates are controlled by each payer and by the state, and nothing here promises an approval, a timeline or a rate. This page covers payer operations. It isn’t legal, tax or scope of practice advice.