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Addendum Cover Page for Maryland Medical Assistance Program Application FACILITY/ORGANIZATION PT 54 IMD RESIDENTIAL SUD ADULT If you have questions, please contact the Provider Enrollment Helpline
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Residential SUD (Substance Use Disorder) for adults is a form that needs to be filled out to provide information about residential treatment for adults with substance use disorders.
Individuals or facilities providing residential treatment for adults with substance use disorders are required to file the residential SUD form.
You can fill out the residential SUD form by providing accurate and complete information about the residential treatment program for adults with substance use disorders.
The purpose of the residential SUD form is to collect data on residential treatment programs for adults with substance use disorders for monitoring and regulatory purposes.
Information such as the name of the facility, types of services provided, number of residents, treatment approaches, and outcomes must be reported on the residential SUD form for adults.
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