Md. Code Regs. 10.09.58.06

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

Section 10.09.58.06 - Limitations

A. The following services are not covered:

(1) Services not medically necessary;

(2) Therapeutic abortion;

(3) Transportation services;

(4) EPSDT services;

(5) Services delivered in an in-patient hospital setting or ambulatory surgical center other than:

(a) Permanent sterilizations; and

(b) A hysterosalpingogram following the Essure procedure;

(6) Infertility services, including reversal of sterilization; and

(7) Any service not listed in Regulation .05 of this chapter.

B. Limitations for advanced practice nurse services covered under this chapter are those set forth in COMAR 10.09.01.05.

C. Limitations for physician services covered under this chapter are those set forth in COMAR 10.09.02.05B.

D. Limitations for free-standing clinic services covered under this chapter are those set forth in COMAR 10.09.08.07B.

E. Limitations for pharmacy services covered under this chapter are those set forth in COMAR 10.09.03.05B.

F. Limitations for medical laboratory services covered under this chapter are those set forth in COMAR 10.09.09.05B.

G. Limitations for acute hospital services covered under this chapter are those set forth in COMAR 10.09.92.05.

H. Limitations for physician assistant services covered under this chapter are those set forth in COMAR 10.09.55.05.

I. Limitations for ambulatory surgery centers covered under this chapter are those set forth in COMAR 10.09.42.05.

Md. Code Regs. 10.09.58.06

Regulations .06 adopted as an emergency provision effective October 19, 1994 (21:23 Md. R. 1930); adopted permanently effective April 10, 1995 (22:7 Md. R. 536)
Regulation .06A amended effective August 27, 2007 (34:17 Md. R. 1507)
Regulation .06A amended as an emergency provision effective January 1, 2012 (39:2 Md. R. 139); amended permanently effective June 11, 2012 (39:11 Md. R. 686); amended effective 45:26 Md. R. 1243, eff. 12/31/2018