Maryland

Under Md. Code Ann., Alcoholic Beverages and Cannabis § 36-101(m) and the MCA Providers page, a "Certifying Provider" in Maryland includes:

• Physicians (MD or DO)
• Physician Assistants (PA)
• Advanced Practice Registered Nurses (APRN), including Nurse Practitioners
• Certified Nurse Midwives
• Dentists
• Podiatrists

All must hold an active, unrestricted Maryland professional license in good standing with the respective Maryland State Board and an active State Controlled Dangerous Substances (CDS) registration.

Physician Assistants must also have an active delegation agreement with a primary supervising physician who is a registered Certifying Provider. A PA may only certify conditions within the primary supervising physician’s scope of practice.

A written certification is not a prescription. It reflects your clinical determination that the patient has a qualifying condition that may benefit from cannabis treatment.

All Certifying Providers must register with the MCA through the OneStop Portal before issuing any written certifications.

Required for registration:

• Active, unrestricted Maryland professional license (Board of Physicians, Dental Examiners, Podiatric Medical Examiners, or Board of Nursing)
• Maryland Controlled Dangerous Substances (CDS) Registration Number
• Physician Assistants must also provide the license number of their primary supervising physician who holds an active delegation agreement

Registration process:

• Visit the MCA OneStop Portal and click Create Account under the Provider heading
• Initial registration is valid for two years or until your Maryland Board license expires, whichever comes first; renewal is also valid for two years.

The Compassionate Use Fund allows Certifying Providers to offer a $50 discount off the standard assessment fee for Medicaid and VA patients. The MCA reimburses Certifying Providers for these discounted assessments.

During registration, you will specify the qualifying conditions you plan to treat and any inclusion or exclusion criteria you apply to patients.

• Cachexia or anorexia
• Severe or chronic pain
• Severe nausea
• Seizures
• Severe or persistent muscle spasms
• Glaucoma
• Post-traumatic stress disorder (PTSD)
• Wasting syndrome

Certifying Providers may also issue written certifications for any severe, chronic medical condition unresponsive to conventional treatment, in the provider’s professional judgment. 

Step 1: Confirm the bona fide provider-patient relationship.

Maryland law requires a bona fide provider-patient relationship before a written certification may be issued. This means reviewing the patient’s relevant medical records; completing an in-person or telehealth assessment of the patient’s medical history and current medical condition; creating and maintaining medically standardized records; and monitoring patient progress and taking any medically indicated follow-up action.

Step 2: Determine that the patient has a qualifying condition within your scope of practice.

Confirm that the patient’s condition meets the statutory criteria: the condition is severe, other medical treatments have proven ineffective, and the patient’s symptoms can reasonably be expected to be relieved by medical cannabis.

Step 3: Conduct the clinical evaluation.

Telehealth certifications are permitted under COMAR 14.17.04, consistent with your licensing board’s telehealth standards. An in-person assessment is not required as a precondition for initial certification, provided a bona fide provider-patient relationship exists and the telehealth evaluation meets your board’s standards.

Step 4: Issue the written certification through the MCA Provider Registry.

Log in to the MCA Provider Registry and complete the written certification. The 120-day window for the patient to use the certification at a licensed dispensary begins on the date of issuance. You may amend or revoke a certification on any medical grounds, including if the patient no longer meets your inclusion criteria or now meets your exclusion criteria.

Step 5: Maintain records.

Document your evaluation and certification in the patient’s medical record in accordance with COMAR 14.17.04 and your licensing board’s standards.

For additional information, visit the  MCA Provider FAQ.

Before renewing a written certification, the Certifying Provider must conduct a full assessment of the qualifying patient. This assessment must occur within 365 days before the renewal certification date. The full assessment for renewal may be conducted via telehealth as defined by the Certifying Provider’s licensing board.

Medical professionals have a legal right to recommend cannabis as a treatment in any state, as protected by the Medical Marijuana and Cannabidiol Research Expansion Act (Title III, Section 301), which became law on December 2, 2022, and the First Amendment, as established by a 2004 United States Supreme Court decision upholding earlier federal court rulings that physicians and their patients have a fundamental constitutional right to freely discuss treatment options.

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