MedicaidAdministrativeHigh impact
PT 13-26: Requirements for Providers Referring to Psychiatric Rehabilitation Programs
Maryland Medicaid·MD · Psychiatry·Specialty Services
Effective date
Sep 1, 2025
We identified it
Jun 18, 2026
Summary
Effective September 1, 2025, all mental health practitioners referring patients to psychiatric rehabilitation programs (PRPs) must maintain active Maryland Medicaid enrollment. Starting January 1, 2026, PRP claims will be denied if the referring provider's NPI is not from an actively enrolled Maryland Medicaid provider.
Action Required
By September 1, 2025: All licensed mental health practitioners who refer to PRPs must enroll with Maryland Medicaid as active providers. OMHCs must enroll all individual providers. Practitioners not billing Medicaid can enroll as ORP-only providers (Provider Type 92) via ePrep. By January 1, 2026: Ensure all PRP claims include the referring provider's NPI from actively enrolled providers - claims will be denied without proper enrollment.