Credentialing by state / Maryland
Nurse Practitioner Credentialing in Maryland
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
| NP practice environment | Full Practice (AANP) |
|---|---|
| Licensing authority | The Maryland board of nursing alone |
| Medicare contractor | Novitas Solutions, jurisdiction JL |
| Medicaid | Maryland Medicaid (HealthChoice), enrolled through ePREP, the Maryland electronic Provider Revalidation and Enrollment Portal |
| Medicaid managed care | 9 plans, 1,665,870 members (2024) |
| Blue Cross Blue Shield plan | CareFirst BlueCross BlueShield |
Maryland Is a Full Practice State
The American Association of Nurse Practitioners classifies Maryland as full practice: state law lets nurse practitioners evaluate patients, diagnose, order and interpret tests, and prescribe under the exclusive licensure authority of the state board of nursing. 28 of the 50 states and DC have that classification.
For credentialing, full practice means the application is about you alone. Maryland Medicaid (HealthChoice) and the commercial plans in Maryland generally do not ask for a collaborating physician, so the fields that hold up NP files in other states are simply absent. Medicare's rule for NP services (42 CFR 410.75) defers to state law on collaboration, and where state law is silent it expects the NP to document their scope of practice and how they work with physicians on issues outside it. Enrollment itself runs through PECOS and Novitas Solutions on the CMS-855I like any other independent practitioner.
What still slows Maryland NPs down is the business side: an NP-owned entity needs its own Type 2 NPI, a group enrollment and a reassignment for each clinician, and some commercial plans review NP-owned practices more slowly than physician groups. If you are new to independent practice, confirm with the board whether any transition-to-practice hours apply to you before the applications go in, because payers will ask for the license status that results.
Maryland Medicaid (HealthChoice) Managed-Care Plans for NPs
After the state enrollment, each managed-care plan credentials you as its own application. The largest in Maryland by 2024 enrollment:
- Priority Partners: 384,354 members
- Wellpoint Maryland: 350,641 members, owned by Elevance Health
- Maryland Physicians Care: 266,727 members
See all 9 plans.
Neighboring States
If you practice near the border or by telehealth, the rules change at the state line: Pennsylvania is reduced practice, Virginia is restricted practice, West Virginia is reduced practice. Washington, DC, Delaware share Maryland's classification.
- Washington, DC NP credentialing (Full Practice)
- Delaware NP credentialing (Full Practice)
- Pennsylvania NP credentialing (Reduced Practice)
- Virginia NP credentialing (Restricted Practice)
- West Virginia NP credentialing (Reduced Practice)
The full NP checklist, the entity decision and where applications stall are in our nurse practitioner credentialing guide. For Medicare, Medicaid and commercial plans for every clinician type in the state, see credentialing in Maryland.
Questions Maryland NPs Ask
Do Maryland nurse practitioners need a collaborating physician to get credentialed?
No. AANP classifies Maryland as full practice, so payers generally do not require a collaborating physician on an NP application. Check with the board of nursing whether any transition-to-practice requirement applies to a newly licensed NP.
How does a Maryland NP join Maryland Medicaid (HealthChoice)?
Enroll with the Maryland Department of Health through ePREP, the Maryland electronic Provider Revalidation and Enrollment Portal. Most Maryland Medicaid (HealthChoice) members are in managed care (1,665,870 enrolled across 9 plans in 2024), so after the state enrollment is active, each plan you want, such as Priority Partners, Wellpoint Maryland, Maryland Physicians Care, credentials you separately.
Can an NP licensed in Maryland see patients in a neighboring state?
Only with a license from that state, and each state's practice rules apply to the patients there. Washington, DC is full practice; Delaware is full practice; Pennsylvania is reduced practice; Virginia is restricted practice; West Virginia is reduced practice. Payer enrollment is also per state, so seeing patients across the line means a separate Medicaid enrollment and separate commercial applications there.
What does PECS charge a Maryland NP?
CAQH (DataSpring) profile build $500; Medicare enrollment $500; Maryland Medicaid (HealthChoice) enrollment $500; each commercial application, including CareFirst BlueCross BlueShield, $200 per provider. Enrollment services bill 50% at engagement and 50% at submission.
Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Sources: American Association of Nurse Practitioners, State Practice Environment (updated May 2026); KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Practice classification is AANP's; confirm current rules with the Maryland board of nursing. Updated October 7, 2026.