Maryland MPRIME Hold: Therapist Guide

Last updated: July 29, 2026.

Before August 1: if your Maryland Medicaid enrollment is a limited-risk provider type, complete and submit any needed new or update application in ePREP before the hold begins. On or after August 1: do not expect ePREP to hold your place in line. Maryland says new and updated applications submitted during the applicable hold will be returned without processing. Prepare for MPRIME, which is planned to launch in October, and treat any possible backdate as conditional rather than guaranteed.

The most important therapist-specific detail is that the deadline follows the Maryland Medicaid provider type, not simply the clinician’s license. Maryland lists many independently licensed behavioral-health professionals in the August 1 limited-risk group, but it lists outpatient mental health clinics and some therapy groups in the earlier July 1 group. A practice may therefore have more than one timeline under the same roof. See Maryland’s provider-type attachments.

What the MPRIME Hold Actually Changes

Maryland Medicaid plans to replace its current Electronic Provider Revalidation and Enrollment Portal (ePREP) with the Maryland Provider Registration and Information Management Enterprise (MPRIME) in October 2026. The transition covers new enrollments, update applications, changes of ownership, and other enrollment functions currently handled in ePREP. Read Maryland’s June MPRIME update.

• July 1, 2026: the application hold began for moderate- and high-risk provider types.

• August 1, 2026: the application hold begins for limited-risk provider types.

• October 2026: Maryland’s public milestone page says MPRIME will go live and the application holds will end. It does not publish a specific October date on that page.

This is an enrollment-system hold, not an announced change to therapy codes, reimbursement rates, coverage, or clinical authorization rules. The immediate operational problem is narrower: a provider who needs a new enrollment or provider-file update may be unable to get that work processed until MPRIME is available.

Which Therapy Providers Have Which Hold Date?

Maryland’s official transition notice divides provider types by screening risk. These are the behavioral-health examples most likely to matter to therapy practices; the attachments contain the full lists.

August 1: Limited-Risk Examples

• Certified Professional Counselor, PT CC: LCPC, LCMFT, LCADC, and LC-PAT.

• Social Worker, PT 94: LCSW-C.

• Psychologist, PT 15.

• Nurse Psychotherapist, PT 24: APRN-PMH.

• Mental Health Group Therapy Provider, PT 27.

• Applied Behavior Analysis Services, PT AB.

July 1: Earlier Behavioral-Health Examples

• Outpatient Mental Health Clinic, PT MC.

• Therapy Group Providers–EPSDT, PT 28.

• Mobile Treatment Program, PT MT.

• Psychiatric Rehabilitation Services Facility, PT PR.

• Substance Use Disorder Program, PT 50.

Do not translate “my therapist license is limited-risk” into “every application for my practice had an August 1 deadline.” Check the PT code on the enrollment record and the provider type involved in the specific application. An individual clinician, a mental health group, and a clinic enrollment can have different classifications.

Before August 1: A Practical Checklist

1. Inventory every open enrollment task. Include new individual or group enrollments, additions or affiliations, ownership work, service-location changes, and other provider-file updates. Maryland says the transition covers all enrollment features, not only first-time applications.

2. Match each task to its Maryland provider type. Use the PT code on the provider record or application. If the type appears in the July 1 list, its hold has already begun; do not assume August 1 still applies.

3. Complete and submit eligible ePREP work. Maryland tells providers to make every effort to submit new or update applications before the applicable hold. Review required license, ownership, address, and supporting-document fields before submission so the application is not merely started or left incomplete.

4. Save operational evidence. Keep the submission confirmation, application identifier, submitted provider type, and a copy of the supporting packet. This is Bomi’s recordkeeping recommendation, not a separate Maryland requirement.

5. Handle a known practice move now. Maryland says a practice-address change can be submitted before the hold with the anticipated effective date of the move.

6. Assign an owner for MPRIME training. Maryland’s July training notice covers registration, new enrollment, update applications, and revalidation, with each training offered several times and recordings planned. Review the MPRIME training notice.

If the Hold Has Already Started

Submitting into ePREP after the applicable hold begins does not create a queue position. Maryland says the application will be returned without processing. Instead, prepare a clean application packet, monitor the official MPRIME page for launch instructions, attend training, and be ready to submit in MPRIME after go-live.

Backdating Is Limited to Certain New Enrollments

Maryland created potential backdating relief for newly enrolling providers. A newly enrolling provider who submits a complete, correct, and processable MPRIME application on or before December 31, 2026 may be eligible for an enrollment effective date backdated to the later of:

• the start of that provider type’s hold—July 1 for high- or moderate-risk types, or August 1 for limited-risk types; or

• the provider’s license issuance date.

Backdating is not assured. An incomplete, incorrect, or otherwise unapprovable application can be returned for correction. A provider who does not submit a processable application by December 31 is not eligible for this transition backdate. Maryland’s notice describes this relief for new enrollments; it does not promise the same remedy for every update application.

Approval Still Controls Billing and Payment

The state says a provider cannot bill or be paid for claims before the enrollment application is approved. If Maryland approves the application and grants the backdate, the provider should promptly submit claims for services in the backdate period. The usual 12-month timely-filing deadline still runs from each date of service.

The cash-flow warning is real: Maryland says providers who furnish services while unenrolled do so at risk. If the provider does not enroll after the hold, the services will not be paid, and the provider may not bill the Medicaid participant for those services. Do not build a staffing or clinical-continuity plan around an assumed backdate.

The Emergency Exception Is Narrow

Maryland offers an emergency process only when failure to enroll immediately would affect the health, safety, and wellbeing of Medicaid participants. A general desire to avoid an enrollment delay or protect revenue does not, by itself, match the published standard.

Email [email protected] with the subject Request for Emergency Enrollment Hold Exception and include:

• the provider NPI;

• the provider type;

• the service address; and

• the specific circumstances that make immediate enrollment necessary for participant health, safety, or wellbeing.

Maryland will approve, deny, or request more information. Approval is not automatic; approved providers receive separate instructions for submitting the emergency application.

Address Changes Follow Three Different Rules

• Practice address: submit before the applicable hold with a future effective date if possible. Otherwise wait for MPRIME; Maryland says the change can then be made retroactively effective.

• Pay-to address for paper checks: use the emergency-exception path and paper application workflow so payment information can be updated during the hold.

• Correspondence address: wait until MPRIME goes live. Maryland says it does not expect an operational effect because its communications are primarily electronic.

What This Means for Therapy Practices

For a solo clinician, the August 1 list includes several familiar license-based provider types, but the PT code still matters. If a new enrollment is not submitted in time, separate the clinical decision about serving Medicaid participants from the financial assumption that Maryland will later pay. The state expressly says service during the gap is at the provider’s risk.

For a group practice, one spreadsheet row labeled “Maryland credentialing” is not enough. Track the individual clinician enrollment, organization or group enrollment, provider type, NPI, application purpose, applicable hold date, and submission evidence separately. An NPI classification and a Maryland PT code answer different questions; if that distinction is unclear, start with our NPI Type 1 vs. Type 2 explainer.

For a practice hiring during the hold, confirm which enrollment must be approved before the clinician’s claims can be paid, then model the gap without assuming backdating. Maryland says additional information about prior authorization for services rendered by unenrolled providers will come in a future transmittal, so that issue is not fully resolved in the current guidance.

What This Likely Means Next

This section is operational inference, not a Maryland promise. Because MPRIME will take over the full enrollment workflow, the durable task is not simply beating one deadline. Practices will need a reliable owner for portal registration, provider-type mapping, application documents, update requests, and follow-up after approval.

The current notices do not promise an exact October launch date, a processing time, or a guaranteed backdate. A safer preparation plan is to stage a complete application packet, register for training, monitor Maryland’s official page, and keep a date-of-service claims log for any services furnished during the gap. That will not guarantee payment, but it prevents a system transition from becoming an information-reconstruction project.

Questions Maryland Therapists Are Asking

Is my Maryland therapy license a limited-risk provider type?

PT 59-26 lists LCPC, LCMFT, LCADC, LC-PAT, LCSW-C, psychologists, and nurse psychotherapists among limited-risk provider types. But a clinic or group enrollment can have a different PT code and an earlier hold. Confirm the provider type on the actual enrollment or application.

Can I submit an ePREP application after August 1?

Not for a provider type whose hold is active. Maryland says new and updated applications submitted during the applicable hold will be returned without processing. Prepare to use MPRIME after it launches.

Will Maryland backdate my enrollment after MPRIME launches?

Maybe, but only under the published conditions for certain newly enrolling providers. The MPRIME application must be complete, correct, processable, and submitted on or before December 31, 2026. Even then, Maryland says a backdate is not assured.

Can I keep seeing Medicaid patients during the hold?

Maryland’s notice does not say the hold itself requires a provider to stop care. It does say an unenrolled provider cannot bill or be paid before approval, provides services at financial risk, and may not bill the participant if those services are not paid because the provider failed to enroll. Apply that guidance to the provider’s enrollment status, clinical obligations, and actual service arrangement, and ask Maryland directly when the situation is unclear.

Who can answer a Maryland MPRIME question?

Email [email protected] for MPRIME questions. Maryland also says the provider enrollment call center will remain open at 1-844-463-7768 before and after the transition.

Where Bomi Fits

Shameless plug: if mapping PT codes, separating individual and group enrollments, and keeping a transition claims log sounds like an unpleasant second job, Bomi is very happy to take that job. We help therapy practices keep credentialing and billing operations attached to the right provider record without turning the owner into a full-time portal archaeologist.

This article summarizes public Maryland Medicaid guidance for operational education. It is not legal, compliance, clinical, or payer advice. Confirm current instructions with Maryland Medicaid and apply them to the provider types and enrollment records your practice actually uses.

Sources

• Maryland Medicaid — MPRIME New Provider Enrollment Portal

• PT 94-26 — MPRIME Updates, June 18, 2026

• PT 59-26 — Provider Enrollment Portal Transition and Provider-Type Attachments

• PT 04-27 — Upcoming MPRIME Training Sessions