Md. Code Regs. 10.09.33.09

Current through Register Vol. 51, No. 20, October 4, 2024

Section 10.09.33.09 - Payment Procedures

A. The Department shall reimburse the health home for covered services according to the requirements in this chapter and the rate established in §C of this regulation.

B. Request for Payment.

(1) The health home provider is authorized to bill for the intake and ongoing monthly rate for a participant when:

(a) The participant is receiving PRP, MTS, or OTP services; and

(b) The intake portion of the participant's eMedicaid file has been submitted and initial services have been delivered.

(2) After completing the required health home service provision reporting in eMedicaid, the health home provider shall, within 30 days from the end of the month during which health home services were provided, submit a request for payment for all participants who received two health home services during that month.

(3) A health home provider shall bill the Department for the appropriate rate specified in §C of this regulation.

C. The Department shall reimburse according to the following fee schedule:

(1) For dates of service from July 1, 2022, through June 30, 2023, at a monthly rate of $127.21 per participant; and

(2) Effective July 1, 2023, at a monthly rate of $131.03 per participant.

Md. Code Regs. 10.09.33.09

Effective date: 40:19 Md. R. 1544, eff.9/30/2013 ; amended effective 43:21 Md. R. 1166, eff. 10/24/2016; amended effective 44:26 Md. R. 1215, eff. 1/1/2018; amended effective 46:26 Md. R. 1164, eff. 12/30/2019; amended effective 49:7 Md. R. 465, eff. 4/4/2022; amended effective 50:22 Md. R. 973, eff. 11/13/2023; amended effective 51:18 Md. R. 808, eff. 9/16/2024.