... brought to you by the Maryland Department of Health
Enroll as a temporary Maryland Medicaid provider for COVID-19 state of emergency
This platform should only be used by providers who are serving Maryland Medicaid participants during the COVID-19 state of emergency.
This is ONLY for NEW, individual provider use. If you are enrolling a group or facility, email firstname.lastname@example.org for more information.
To enroll as a permanent Medicaid provider (i.e. during and beyond the state of emergency), please submit a new enrollment application through ePREP (eprep.health.maryland.gov).
Before beginning the application process, please provide the following
(As the person completing this form, you are required to enter your own
name and contact information. Do not enter the Provider's name unless you yourself are the Provider.)