Behavioral Billing® Credentialing Guide
Maryland Medicaid / HealthChoice
Credentialing and revenue-cycle enrollment reference for behavioral health and speech therapy practices. Start with your provider type: the credentialing route may differ even when the insurance brand is the same.
Choose the correct provider pathway
Do not assume behavioral-health participation includes speech therapy, or that an SLP network contract includes behavioral-health services.
Mental / Behavioral Health provider
Behavioral-health credentialing route
Enroll with Maryland Medicaid. For specialty behavioral health, complete the Carelon registration/participation path in addition to state enrollment.
Open BH credentialing source ↗Speech Therapy provider
Speech / therapy credentialing route
Enroll with Maryland Medicaid as the therapy provider type. Ages 0–20 SLP routes to Maryland Medicaid FFS under EPSDT; age 21+ generally follows the member's HealthChoice MCO/product.
Open speech credentialing source ↗Where the pathways differ: Major split: specialty BH is carved out to Carelon; pediatric SLP is FFS/EPSDT; adult SLP generally follows the MCO. Carelon is not the SLP credentialing route.
Shared credentialing + network setup
Credentialing prerequisitesProvider/group must be enrolled with Maryland Medicaid; state provider data must be current.Open source ↗
Network / payer enrollmentComplete Maryland Medicaid enrollment. Use current MPRIME transition authority; HealthChoice MCO network enrollment remains separate.Open source ↗
State Medicaid enrollmentRequired — Maryland Medicaid enrollment. For specialty BH also register with Carelon as applicable.Open source ↗
Portal / identity setupMaryland Medicaid provider access plus EVS/eMedicaid/MMEE; MCO portal as applicable.Open source ↗
Revenue-cycle enrollment
EDI / claims enrollmentMaryland Medicaid FFS supports 837 through MMEE; MCO claims use child-plan EDI route.Open source ↗
ERA enrollmentEnroll state/MCO remittance according to the actual FFS or MCO payer route.Open source ↗
EFT enrollmentEnroll state/MCO EFT according to the actual FFS or MCO payer route.Open source ↗
Clearinghouse / EDI routeMMEE/eMedicaid for FFS; child-plan route for MCOOpen source ↗
Payer IDFFS/MMEE or child-MCO specificOpen source ↗
Before you start billingConfirm state enrollment, MCO participation, age/service routing, claim destination, remittance and payment path before billing.Open source ↗
Before you bill: provider credentialing, specialty network participation, EDI, ERA, and EFT are separate checkpoints. Verify the correct specialty network before treating the first member.
Last reviewed: 2026-10-03 · Program requirements reviewed
Payer processes change. Reverify the current payer instructions before submitting an application or changing a production billing configuration.