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Maryland - Speech & Language Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Maryland Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists & Music Therapists licenses Speech-Language Pathologists under COMAR 10.41.03.03 to provide evaluation and treatment for communication, cognition, and swallowing. Medicaid reimbursement for these services is administered by the Maryland Department of Health (MDH) through the HealthChoice managed care program, the EPSDT School Health-Related Services program, and Developmental Disabilities Administration (DDA) waivers such as the Community Pathways Waiver.

Approval to bill Maryland Medicaid requires active state licensure followed by enrollment through the electronic Provider Revalidation and Enrollment Portal (ePREP). Providers seeking to serve participants in DDA waivers must first secure DDA provider approval and complete specific waiver training before their Medicaid enrollment is finalized for those specific billing codes.

1. Service Definition and Scope

In Maryland, Speech-Language Pathology services encompass the application of principles, methods, and procedures related to the development and disorders of human communication. This includes evaluating and treating speech, language, swallowing, and cognitive-communication disorders.

Under Medicaid, these services are delivered across various settings, including independent clinics, schools under the EPSDT program (COMAR 10.09.50), and home and community-based settings via DDA waivers.

2. Regulatory and Oversight Agencies

The primary regulatory body for the profession is the Maryland Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists & Music Therapists. This board issues both full and limited licenses.

The Maryland Department of Health (MDH) oversees Medicaid enrollment and billing, while the Developmental Disabilities Administration (DDA) manages waiver-specific provider approvals.

3. Gatekeeping Prerequisites: Who Can Even Apply

Maryland does not require a Certificate of Need (CON) for independent Speech-Language Pathology practices. The primary structural precondition is obtaining a state license from the Board of Examiners.

For providers intending to bill through DDA waivers, an active DDA provider application and approval are required before ePREP enrollment for waiver services can be completed. There is currently no moratorium on SLP provider enrollment, unlike certain behavioral health provider types in specific Maryland counties.

4. Licensure and Certification Requirements

Licensure in Maryland is governed by COMAR 10.41.03.03. Applicants must demonstrate good moral character, hold a qualifying Master's degree, and pass the national examination.

While the American Speech-Language-Hearing Association (ASHA) Certificate of Clinical Competence (CCC) is not strictly required by the state, holding it significantly streamlines the application process by waiving certain documentation requirements.

5. Medicaid Provider Enrollment

All Medicaid provider enrollments, revalidations, and demographic updates in Maryland must be processed through the electronic Provider Revalidation and Enrollment Portal (ePREP).

Providers must enroll as an individual practitioner or as a group practice. After ePREP approval, providers must separately credential and contract with individual HealthChoice MCOs to serve managed care populations.

6. Staffing, Training and Background Checks

Independent SLP practices must ensure all employed or contracted personnel hold appropriate active licenses. Speech-Language Pathology Assistants must be licensed and practice under the direct supervision of a fully licensed SLP.

Providers serving DDA waiver participants must complete specific DDA-mandated trainings, including incident management and person-centered planning.

7. Documentation, Policies and Records

Maryland Medicaid requires providers to maintain comprehensive clinical and financial records for a minimum of six years. Documentation must support the medical necessity of the services billed.

For EPSDT and waiver services, documentation must align with the participant's Individualized Education Program (IEP) or Person-Centered Plan (PCP).

8. Billing, Rates and Claims

Reimbursement rates for fee-for-service Medicaid are established by the MDH fee schedule. MCO rates are negotiated individually but generally align with the state fee schedule.

Prior authorization is frequently required for ongoing treatment beyond initial evaluations, particularly within the HealthChoice MCO networks.

9. Approval Sequence and Timeline

The process begins with obtaining the state license, which can take 4-8 weeks after submitting all transcripts and exam scores. Once licensed, the ePREP Medicaid enrollment process typically takes 30-60 days.

MCO credentialing is the final step and can add an additional 60-90 days before a provider is fully in-network and able to bill for managed care patients.

10. Common Denials and Survey Findings

Licensure applications are most frequently delayed due to missing official transcripts or incomplete CFY supervision plans. The Board will not issue a Limited License until the supervision plan is fully approved.

Medicaid ePREP applications are often returned for corrections if the NPI taxonomy does not match the provider type or if the uploaded license copy is expired or illegible.

11. Key Contacts and Resources

Providers should utilize the official state portals for the most current regulations, fee schedules, and application forms. The ePREP system provides a dedicated support desk for enrollment issues.

The Board's website offers online license verification and specific forms for CFY supervision plans and license renewals.

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