Provider Gambling Services Referral Sign Up Form

The Maryland Department of Health, Behavioral Health Administration, in collaboration with Optum Maryland, will reimburse providers and private practitioners for providing gambling treatment services at No Cost to Maryland residents seeking help.  If you are an eligible provider, with applicable coding you can receive reimbursement directly through Medicaid or through the Problem Gambling Fund.

By completing this application, you are indicating that you would like to be a part of the MD Provider Referral Directory to offer No Cost Treatment for gambling to the individual or others impacted by gambling related harms.  The MD Center of Excellence on Problem Gambling will review the application for accuracy and your practice to the Referral Directory.