Md. Code Regs. 10.09.88.05

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

Section 10.09.88.05 - Limitations

The Program does not cover the following:

A. Services for which the portable X-ray provider cannot provide a properly completed order identifying the authorized ordering physician or practitioner by National Provider Identifier (NPI);

B. Services not adequately documented in the recipient's medical record;

C. Services not medically necessary;

D. Procedures that are known by the provider as investigational or experimental in nature;

E. Services which are specifically included as an integral part of another service;

F. Consultations;

G. Office visits;

H. Injections;

I. Surgeries; and

J. Therapeutic services.

K. X-ray services ordered by an:

(1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

(2) Entity, facility, or another provider that is not an individual.

Md. Code Regs. 10.09.88.05

Effective date: 41:8 Md. R. 472, eff.4/28/2014 ; amended effective 44:26 Md. R. 1214, eff. 1/1/2018