Md. Code Regs. 10.09.30.07

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.30.07 - Payment Procedures

A. Request for Payment.

(1) Requests for payment of services rendered shall be submitted according to procedures established by the Department. Payment requests which are not properly prepared or submitted may not be processed, but shall be returned unpaid to the provider.

(2) Requests for payment shall be submitted on the form specified by the Department.

B. Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.

C. Effective July 1, 2022, payments for comprehensive evaluations shall be made in accordance with the fee schedule below:

When conducted for any purpose other than the Preadmission Screening and Resident Review (PASRR) using the Department's preferred tool	$482.95
When conducted for the purpose of determining eligibility for any services that are not reimbursed by Medicaid or for the purpose of Geriatric Evaluation Services using the tool that is not preferred by the Department	$370.00
When conducted for the purpose of PASRR and does not require a psychological or psychiatric review	$370.00
When conducted for the purpose of PASRR and requires a psychological or psychiatric review	$440.00
When conducted for the purpose of PASRR and requires a psychological and psychiatric review	$510.00
When conducted for the purpose of PASRR and requires a psychological or psychiatric evaluation	$570.00
When conducted for the purpose of PASRR and requires a psychological evaluation and a psychiatric review or a psychiatric evaluation and a psychological review	$640.00
When conducted for the purpose of PASRR and requires both a psychological and psychiatric evaluation	$770.00

Md. Code Regs. 10.09.30.07

Regulations .07 adopted as an emergency provision effective October 21, 1986 (13:23 Md. R. 2477); emergency status extended at 14:2 Md. R. 125; adopted permanently effective January 27, 1987 (14:2 Md. R. 129); amended and recodified from .06 effective 50:24 Md. R. 1041, eff. 12/11/2023