****PLEASE NOTE: The information on this page applies to Maryland Medicaid Substance Use Disorder services delivered on or after 1/1/2015. For questions pertaining to service delivery prior to 1/1/2015, please email dhmh.MedicaidSUD@maryland.gov.


Substance Use Disorder Services

On January 1, 2015, the Maryland Department of Health and Mental Hygiene (DHMH) launched an integrated Public Behavioral Health System (PBHS), including mental health and substance use disorder (SUD) services. The Department has contracted with an Administrative Service Organization, ValueOptions to assist with the management of the PBHS.


As a result of Behavioral Health Integration, SUD services have been "carved-out" of Maryland Medicaid's HealthChoice managed care program and are now administered along with Mental Health Services by ValueOptions. To learn more about the Behavioral Health Integration process, click hereAs a result of the carve-out, managed care organizations (MCOs) are not responsible for payment to SUD providers for claims with dates of service after 12/31/2014.


In order to receive Medicaid payment for SUD services delivered after 12/31/2014, providers must be enrolled with Maryland Medicaid AND registered with the ValueOptions. Programs serving participants with a substance use disorder must obtain certification from the Office of Health Care Quality and submit an application to Medicaid as a SUD program. Medicaid SUD program types include the following:

·         Methadone Maintenance Providers (provider type 32)

·         Certified Addiction Programs (provider type 50)

·         Intermediate Care Facility–Addictions (provider type 55) for individuals under the age of 21


Additional information regarding SUD provider registration, services, and claims is available on the Maryland ValueOptions webpage, click here.


To enroll as a Medicaid provider, complete and submit the provider application and agreement found here: http://dhmh.maryland.gov/providerinfo.

 

 
Last Update 1/30/2015