The Fee-for-Service (FFS) Medicaid-enrolled pharmacist providers can bill Maryland Medicaid for professional services rendered within their lawful scope of practice.
Pharmacist professional services include:
If you are a pharmacist who wants to bill FFS Medicaid for your services, you must be enrolled as a participating provider through ePREP, Maryland Medicaid's online Electronic Provider Revalidation and Enrollment Portal.
Enroll to Become a Maryland FFS Medicaid Pharmacist Provider (PT PH)
This is a two-part process; both the pharmacy and pharmacist will have to enroll.
A licensed pharmacy must :
- Have a type 2 National Provider Identifier (NPI) or obtain through the National Plan and Provider Enumeration System (NPPES) for the location it intends to enroll as a pharmacy.
- Enroll as a pharmacist group and affiliate with at least one rendering pharmacist to submit the application.
- The individual qualified pharmacist must enroll as a rendering pharmacist.
- Any individual pharmacist who does not have a type 1 NPI will need to obtain one to apply as a pharmacist.
Required ePREP Application Documents
You will need to upload additional documents with your ePREP application. For more information, see
FFS Reimbursement Rates
For rates, see the Professional Providers Manual.
FFS Billing
For billing and coding information, see Fee-For-Service Claims Guidance for CMS 1500 Billing Instructions.
FFS Payment
Note that Medicaid makes payment to the pharmacy, not the pharmacist.
Resources
Contact
For more information or questions, email mdh.pharmacistsprofservices@maryland.gov.
