Md. Code Regs. 10.09.10.09-1

Current through Register Vol. 51, No. 12, June 14, 2024

Section 10.09.10.09-1 - Rate Calculation - Therapy Services for Rates Effective on or Before December 31, 2014

A. Reimbursement for therapy services which meet the conditions as stated in Regulation .04F of this chapter is outlined in §§B-C of this regulation.

B. Physical, Occupational, and Speech Therapy Services.

(1) Physical, occupational, and speech therapy services will be reimbursed in 15-minute increments with a maximum per diem duration of 1 hour.

(2) Reimbursement rates for each type of therapy shall be calculated as a percent of an hourly rate comprised of two components from the Medicare Therapy Services Guidelines and a per diem supply cost. The hourly rate shall be the sum of:

(a) The adjusted hourly salary equivalent amount effective for the period corresponding to the State fiscal year from the Medicare guidelines;

(b) One-sixth of the total travel allowance for the period corresponding to the State fiscal year from the Medicare guidelines; and

(c) A supply allowance established at $0.30 for the period October 1, 1999, through June 30, 2000, and indexed in subsequent years based on the Consumer Price Index for All Urban Consumers (CPI-U), nonprescription medical equipment and supplies component, from U.S. Department of Labor, Bureau of Labor Statistics, CPI Detailed Report, Table 4.

(3) Reimbursement rates shall be established at 25 percent of the hourly rate for a 15-minute therapy session, 50 percent of the hourly rate for a 30-minute therapy session, 75 percent of the hourly rate for a 45-minute therapy session, and 100 percent of the hourly rate for a 60-minute therapy session.

(4) Providers shall be reimbursed based upon the Medicare Therapy Services Guidelines established for the geographic area in which the provider is located.

C. Reimbursement for therapy services is not subject to cost settlement.

Md. Code Regs. 10.09.10.09-1

Regulations .09-1 amended as an emergency provision effective January 14, 1992 (19:3 Md. R. 299); emergency status expired June 30, 1992
Regulations .09-1 amended as an emergency provision effective July 1, 1992 (19:14 Md. R. 1272); amended permanently effective November 1, 1992 (19:21 Md. R. 1891)
Regulations .09-1 amended as an emergency provision effective July 1, 2005 (32:19 Md. R. 1584); emergency status expired August 31, 2005
Regulations .09-1 amended and new Regulation .09-1 adopted as an emergency provision effective October 1, 1999 (26:23 Md. R. 1775); adopted permanently effective January 9, 2000 (26:27 Md. R. 2015)
Regulations .09-1 amended as an emergency provision effective December 1, 2001 (29:1 Md. R. 17)
Regulations .09-1 amended as an emergency provision effective July 1, 1995 (22:15 Md. R. 1114); emergency status expired November 1, 1995; amended permanently effective November 6, 1995 (22:22 Md. R. 1658)
Regulations .09-1 amended as an emergency provision effective July 1, 1996 (23:15 Md. R. 1081); amended permanently effective November 4, 1996 (23:22 Md. R. 1496)
Regulations .09-1 amended as an emergency provision effective July 1, 1997 (24:16 Md. R. 1149) (Emergency provisions are temporary and not printed in COMAR)
Regulations .09-1 amended as an emergency provision effective July 1, 1998 (25:15 Md. R. 1181); amended permanently effective October 19, 1998 (25:21 Md. R. 1574)
Regulations .09-1 amended as an emergency provision effective July 1, 1999 (26:16 Md. R. 1237 and 26:18 Md. R. 1369); emergency status expired September 30, 1999
Regulations .09-1 amended effective 42:7 Md. R. 567, eff.4/13/2015; amended effective 45:13 Md. R. 664, eff. 7/2/2018