The live map did not load. Use the region buttons below the hero instead: Baltimore, Columbia, Rockville, Bethesda, Silver Spring, Frederick, Annapolis, Towson, Germantown, Salisbury, Hagerstown, Bowie.
Select a city to open its region card
Built for solo therapists, psychiatrists and group practices
Maryland Billing Guide for Mental Health Therapists and Psychiatrists
Pick your region, choose who pays you, then follow six steps from first visit to payment. Every fact below links to its official source.
- MedicaidMaryland Medicaid’s managed care program is HealthChoice. The member’s managed care organization pays primary behavioral health, and Carelon is the administrative services organization for specialty services, so check each member’s plan. See the Medicaid section.
- Medicare Part BClaims in Maryland go to Novitas Solutions, the Medicare Administrative Contractor for Jurisdiction L. Details.
- Blue Cross Blue ShieldCareFirst BlueCross BlueShield is a Blue licensee in Maryland, and its rules apply to its own plans. See the Blue Cross section.
- LawState law can change how you bill, including the 30-day clean claim payment rule. Maryland law that changes billing.
Where do you practice?
Maryland payers and Medicaid plans follow where your clients live and which plan they carry. Pick a city to see what to check there and jump to its local guide when one is published.
Map data © OpenStreetMap contributors. Pins mark approximate city locations.
Who pays you?
Rules differ by payer type. Choose one to see what to know, what to do, and where to read more.
Follow one claim, six steps
Most denials trace back to one of these steps. Click a step for what to do this Monday.
Your Monday checklist
Check items off as you go. Your progress stays on this device only.
0 of 8 done
This Maryland billing guide covers Medicaid, Medicare, CareFirst, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Maryland billing guide: how Maryland pays for outpatient care
HealthChoice is Maryland Medicaid's managed care program. The member's managed care organization (MCO) pays for primary behavioral health. Specialty behavioral health goes through the Public Behavioral Health System, which an administrative services organization (ASO) runs. Carelon has been the ASO since January 1, 2025.
Start every Maryland claim by asking which payer owns the member's behavioral health benefit. The right payer decides your enrollment, your filing limit and where the claim goes.
| Payer type | Who you bill | Where to look |
|---|---|---|
| Maryland Medicaid (HealthChoice) | The member's MCO, or the ASO for specialty behavioral health | Behavioral health coverage |
| Medicare Part B | Novitas Solutions, Jurisdiction L | CMS MAC list |
| Blue Cross | CareFirst BlueCross BlueShield | CareFirst provider site |
| Other private plans | Each plan, under its own contract | Maryland insurance contacts |
Maryland Medicaid: HealthChoice and behavioral health
HealthChoice uses nine managed care organizations: Aetna Better Health of Maryland, CareFirst BlueCross BlueShield Community Health Plan Maryland, Jai Medical Systems, Kaiser Permanente, Maryland Physicians Care, MedStar Family Choice, Priority Partners, UnitedHealthcare of the Mid-Atlantic and Wellpoint Maryland.
Primary behavioral health is the MCO's job. Specialty behavioral health runs through the ASO. The state behavioral health coverage page explains which services sit where. Confirm the member's MCO before you bill.
Medicaid filing limit
Maryland Medicaid expects a clean claim within 12 months of the date of service. The state lists exceptions for retroactive eligibility, Medicare explanation of benefits and other-insurance remittances, each with its own window. Read the Medicaid time limits document for the exact rules.
Enrollment
Providers enroll through the ePREP portal, then credential with each MCO or the ASO. See our credentialing and network status guide for the order of steps.
Medicare Part B in Maryland
Novitas Solutions processes Medicare Part B claims for Maryland as part of Jurisdiction L. Medicare generally requires claims within 12 months of the date of service. Check the CMS Medicare Administrative Contractor list for your current contractor, and read our CPT and E/M code guide before you submit psychotherapy and E/M claims.
Blue Cross Blue Shield in Maryland: CareFirst
CareFirst BlueCross BlueShield is the Blue Cross licensee for Maryland. Blue plans are independent, so never apply another state's Blue rules here. Use the CareFirst provider site for plan rules and read our CareFirst Maryland guide.
Other private payers and EAPs in Maryland
Aetna, Cigna, UnitedHealthcare and employee assistance programs each set their own filing windows, authorization rules and credentialing steps. Read each contract, then use our private insurances guide and the Maryland insurance contacts page to find the right channel.
Maryland billing law that affects your claims
Maryland's prompt pay rules cover private carriers. A carrier must pay a clean claim within 30 days of receipt, with interest if it is late. If a claim is not clean, the carrier must send notice within 30 days that names the information it needs. The Maryland Insurance Administration explains prompt pay and clean claims.
State prompt pay law does not reach every plan. Self-funded employer plans and Medicare follow other rules, so keep each payer type in its own bucket.
Maryland billing codes for therapists and psychiatrists
Most Maryland outpatient claims use the same codes as the rest of the country: 90791 for diagnostic evaluation, 90832, 90834 and 90837 for individual psychotherapy, 90846 and 90847 for family therapy and 90853 for group therapy. Psychiatrists bill E/M codes 99202 to 99215, with add-on psychotherapy codes 90833, 90836 and 90838 when the visit includes therapy. Coverage and prior authorization vary by plan, so check each payer. See the CPT and E/M code guide and the billing terms glossary.
Maryland billing guide: what changed, newest first
Check this Maryland billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2025-01-01 | Carelon became the administrative services organization for Maryland's Public Behavioral Health System. | Source |
How do I bill mental health claims in Maryland?
These answers come from the same sources as the rest of this Maryland billing guide.
Start with the member's payer type. For HealthChoice members, bill the member's MCO for primary behavioral health and the ASO for specialty behavioral health. Medicare Part B goes to Novitas Solutions in Jurisdiction L. CareFirst is the Blue Cross plan for commercial members.
Questions about billing in Maryland
Who runs Maryland's specialty behavioral health claims?
An administrative services organization runs them. Carelon has held that role since January 1, 2025.
How long do I have to file a Maryland Medicaid claim?
The state expects a clean claim within 12 months of the date of service, with listed exceptions.
What does Maryland prompt pay law require?
Private carriers must pay clean claims within 30 days of receipt, with interest if late.
Which Blue Cross plan covers Maryland?
CareFirst BlueCross BlueShield is the Maryland Blue Cross licensee.
Does MCM South bill in Maryland?
We currently serve ten states. Request a quote to ask about Maryland.
Sources for the Maryland billing guide
Last checked November 13, 2026. We opened these pages for this guide: HealthChoice behavioral health coverage, Maryland Medicaid time limits and Prompt pay and clean claims.
Also referenced: CMS Medicare Administrative Contractors, CareFirst provider site, Blue Cross Blue Shield Association and U.S. Census QuickFacts for Maryland.
Billing in Maryland. Let us handle the payer calls.
MCM South bills only mental and behavioral health, for psychotherapists and psychiatrists, in solo and medium-size practices. We currently serve ten states; request a quote to ask about Maryland.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.