What's New:

Provider COVID-19 Resources

Check out streamlined resources for our provider network related to COVID-19. 

Provider Access and Availability Requirements

Learn your requirements regarding member appointments and timeframes, and coverage after hours.

Provider Manual

The MedStar Family Choice Provider Manual provides information on the HealthChoice program, the requirements of an MCO, and the requirements of providers participating in MedStar Family Choice.

Provider News

Provider alerts and newsletters include important information for all MedStar Family Choice providers.

Provider Support

Learn about Provider Relations, Case Management, Outreach and other departments that work with and assist providers. 

Diabetes Prevention Program

The CDC National Diabetes Prevention Program (DPP) is now a covered benefit for members of MedStar Family Choice. The DPP is a yearlong lifestyle-change program with a wealth of scientific studies supporting its effectiveness at reducing the risk of developing type 2 diabetes in at-risk individuals.

Pediatric to Adult Healthcare Transition Guide

Learn how to help your adolescent patients successfully transition from a child centered health care to an adult centered health care.

MFC Maternal Child Health Community Services Referrals

This referral service listed above is currently only available to members in Prince Georges County.

Office Laboratory/Pathology Procedure Codes

MedStar Family Choice requires laboratory/pathology procedures to be provided by MedStar Family Choice participating lab(s). The document linked above lists the procedure codes for labs that can be performed in an office setting.

Quick Reference Guide

For MedStar Family Choice contact numbers and information about pre-authorizations.

Interpreter Services

Interpreters for those members who have limited English proficiency or are hearing impaired or sight impaired.

MedStar Family Choice Quick Authorization Guide

A list of services that require pre-authorization.

Quality Monitoring Programs

The Quality Improvement Department works closely with the Maryland Department of Health to ensure our members receive optimum care.

Mental Health and Substance Use Resources for Providers

Learn how to refer a patient to mental health or substance use disorder treatment.

PCP Assignment Changes

To change a member's primary care provider in our records, providers can help them complete the Member PCP Selection Form on the PCP Assignment Changes page.

CLAS Standards Toolkit

View the guide to implementing the National CLAS Standards.

Prior Authorization and Utilization Management

Information on prior authorization and utilization management along with forms.


Primary care providers should use the Maryland Uniform Consultation Referral Form when referring to a specialist provider.

Provider Directory

Use our Find a Doctor tool to locate a provider near your patient.

Billing Guidelines for Developmental/Mental Health Screening and Assessment

These are Maryland Department of Health's coding guidelines for developmental/mental health screenings by primary care providers.

Clinical Practice Guidelines

A listing of clinical practice guidelines for a variety of conditions.

General Medical Records Release and Authorization Form (Spanish)

A form for patients to allow the release of their medical records and authorization for use or disclosure of protected health information.

HPV Public Health Issue/Tools

MedStar Family Choice needs your help in addressing the critical public health issue of under-vaccination of Maryland's adolescents and young adults against the Human Papillomavirus (HPV). The Maryland Department of Health has a variety of tools available for providers.

Living Well Program

Living Well is a seven-week MedStar Health program that helps patients with chronic conditions take charge of their health and their lives.

Maryland Healthy Kids/EPSDT Program

EPSDT is the Early and Periodic Screening, Diagnosis and Treatment Program (also known as the Healthy Kids Program) through the State Medicaid Program. This program establishes preventive care standards for children under the age of 21.

Lead Testing

As a provider, it is important to follow the Lead Testing Schedule as it applies to Medicaid recipients.

Out of Network Doula Services Process for Prior Authorization 

Take a look at the process for Prior Authorization for out of network Doulas. 

Maryland Prenatal Risk Assessment Form

Specialists No Longer In Network

Cultural Diversity

Information current as of: