Md. Code Regs. 10.21.15.06

Current through Register Vol. 52, No. 1, January 10, 2025

Section 10.21.15.06 - Payment Rates

The Department shall pay:

A. Hospitals, at rates approved by the Health Services Cost Review Commission;

B. Physicians, the lesser of the:

(1) Amount billed; or

(2) The Statewide average of prevailing charges for an examination by a physician consultant based on Medicare's 75th percentile as determined according to 42 CFR § 405.504; and

C. Transportation providers, if transportation is by:

(1) Ambulance, the lesser of the:

(a) Amount billed, or

(b) The Statewide average of prevailing charges for an ambulance based on Medicare's 75th percentile; or

(2) A law enforcement officer in an emergency vehicle:

(a) The cost per mile based on the county's established rates for emergency vehicles, and

(b) The cost of the law enforcement officer's hourly wage for the number of hours, not to exceed 4 hours, required to transport the emergency evaluee.

Md. Code Regs. 10.21.15.06