The COMAR 10.63 rewrite: what Maryland behavioral health programs need to know

What just happened

COMAR 10.63 is the subtitle that governs community-based behavioral health programs and services in Maryland. It covers licensing, staffing, documentation, site requirements, and compliance for programs like PRP, OMHC, IOP, and outpatient SUD treatment.

The Behavioral Health Administration has been working toward this rewrite for over a year. A first proposal published in May 2025 drew heavy stakeholder comment and was voluntarily withdrawn that August. BHA then ran listening sessions through late 2025 and revised drafts in December 2025, January, April, and May of 2026. The proposal submitted to the legislature's review committee in July 2026 was published in the Maryland Register on August 21, 2026.

This is not an amendment. It repeals the existing regulations and adopts a new structure for the entire subtitle.

The new structure

The proposed subtitle is organized in four parts.

Chapters .01 through .06 set requirements that apply to every organization: compliance and reporting, staffing, documentation, site requirements, and the licensing process itself.

Chapters .08 through .37 are program-specific. Each program type gets its own chapter with a consistent format: definitions, program description, staffing requirements, services, licensure requirements, and site and documentation requirements. The rewrite also adds a new service type, Mental Health Intensive Outpatient Services.

Chapter .38 establishes civil money penalties for material and egregious non-compliance with federal or state law or regulation.

Chapter .39 provides the framework for corrective actions and sanctions by BHA.

Changes that came from provider feedback

BHA made several notable changes in response to stakeholder comment during the drafting process. The Psychiatric Rehabilitation Association (PRA) was added as a recognized certification for rehabilitation specialists. The blanket prohibition on audio-only telehealth was removed, aligning the regulations with the Preserve Telehealth Access Act of 2025. Clinical supervision language was updated so that appropriately supervised CAC-ADs can provide services. And a definition of dietary services was added to clarify that communal or rehabilitative food preparation by participants does not trigger commercial kitchen requirements.

What this means for your program

Three things stand out to us as operators.

First, documentation is now a universal chapter plus a program-specific chapter. Your documentation requirements will live in two places: the general requirements in the early chapters and whatever your program's own chapter adds. It is worth reading both against what your team produces today.

Second, civil money penalties are new. The penalty framework applies to material and egregious non-compliance, not paperwork slips. But it changes the stakes of an audit, and it makes documentation you can defend more valuable than it already was.

Third, the program chapters follow a consistent template. That makes it easier than it used to be to compare requirements across your programs, and easier to spot where a staffing or documentation requirement changed from the current regulations.

What to do before September 21

Read your program's chapter first, then the general chapters. The full proposed text is on the Maryland Register and linked from BHA's COMAR 10.63 revisions page at health.maryland.gov/regs.

If something in the text would break how your program operates, say so now. Comments are accepted through September 21, 2026, by mail to the Office of Regulation and Policy Coordination at 201 West Preston Street, Room 534, Baltimore, MD 21201, by phone at 410-767-0938, or by email to mdh.regs@maryland.gov. No public hearing has been scheduled, so the written comment period is the opportunity.

Where Mallow fits

We built Mallow inside our own COMAR 10.63 licensed practice, and we will be reading these chapters for ourselves, not just for our customers. When the final regulations land, the documentation templates, program configurations, and compliance checks in Mallow get updated to match, for every practice on the platform at once. That is what an EMR built inside a Maryland practice is for.

If you want to see how Mallow handles 10.63 documentation today, request a demo at mallowhealth.com.