Md. Code Regs. 10.09.50.07

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

Section 10.09.50.07 - Payment Procedures

A. Request for Payment.

(1) An approved provider shall submit a request for payment of services rendered and completed under this chapter as set forth in COMAR 10.09.36.04A. he Department reserves the right to return to the provider, before payment, all payment requests not properly prepared or submitted.

(2) A provider shall submit a request for payment as set forth in COMAR 10.09.36.04A. he completed form shall indicate the:

(a) Date or dates of service;

(b) Participant's name and Medical Assistance number;

(c) Provider's name, location, and provider number; and

(d) Nature, unit or units, and procedure code or codes of covered services provided.

B. Providers may not bill the Program for:

(1) Services not rendered in person, unless the services are provided in compliance with COMAR 10.09.49 and any guidance issued by the Department:

(2) Completion of forms or reports;

(3) Broken or missed appointments; or

(4) Services which duplicate a service that a recipient is receiving under another medical care program.

C. The Program may not make direct payment to a participant.

D. Billing time limitations for services covered under this chapter are the same as those set forth in COMAR 10.09.36.06A.

E. Reimbursement for health-related services and health-related early intervention services is contained in COMAR 10.09.02.07D. he State portion of reimbursement is provided by the Maryland State Department of Education.

Md. Code Regs. 10.09.50.07

Regulations .07 adopted as an emergency provision effective February 2, 1993 (20:4 Md. R. 369); adopted permanently effective June 1, 1993 (20:10 Md. R. 852)
Regulation .07E, F amended effective November 14, 2011 (38:23 Md. R. 1421); amended effective 43:5 Md. R. 386, eff.3/14/2016; amended effective 43:19 Md. R. 1072, eff. 9/26/2016; amended effective 44:4 Md. R. 252, eff. 2/27/2017; amended effective 49:7 Md. R. 466, eff. 4/4/2022