Md. Code Regs. 10.21.25.12

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.21.25.12 - Evaluation and Management Services-Including Medication Management

A. New Patients. The Department shall reimburse for evaluation and management services for new patients, including medication management:

(1) For a problem focused history, or a problem focused examination, and straightforward medical decision making of minor complexity:

(a) OMHC . $48.70;

(b) Physician . $48.70;

(c) Certified registered nurse practitioner-psychiatric . $48.70;

(2) For an expanded problem focused history, or an expanded problem focused examination, and straightforward medical decision making:

(a) OMHC . $82.48;

(b) Physician . $82.48;

(c) Certified registered nurse practitioner-psychiatric . $82.48;

(3) For a detailed history, or a detailed examination, and medical decision of low complexity:

(a) OMHC . $119.25;

(b) Physician . $119.25;

(c) Certified registered nurse practitioner-psychiatric . $119.25;

(4) For a comprehensive history, or a comprehensive medical examination, with medical decision making of moderate complexity:

(a) OMHC . $181.64;

(b) Physician . $181.64;

(c) Certified registered nurse practitioner-psychiatric . $181.64;

(5) For a comprehensive history, or a comprehensive medical examination, with medical decision making of high complexity:

(a) OMHC . $224.53;

(b) Physician . $224.53;

(c) Certified registered nurse practitioner-psychiatric . $224.53.

B. Established Patients. The Department shall reimburse for evaluation and management services for established patients, including medication management:

(1) For a history, or examination, where presenting problems are minimal, and straightforward medical decision making of minor complexity:

(a) OMHC . $22.72;

(b) Physician . $22.72;

(c) Certified registered nurse practitioner-psychiatric . $22.72;

(2) For a problem focused history, or a problem focused examination, and straightforward medical decision making:

(a) OMHC . $48.70;

(b) Physician . $48.70;

(c) Certified registered nurse practitioner-psychiatric . $48.70;

(3) For an expanded history, or an expanded examination, and medical decision of low complexity:

(a) OMHC . $80.11;

(b) Physician . $80.11;

(c) Certified registered nurse practitioner-psychiatric . $80.11;

(4) For a detailed history, or a detailed medical examination, with medical decision making of moderate complexity:

(a) OMHC . $117.60;

(b) Physician . $117.60;

(c) Certified registered nurse practitioner-psychiatric . $117.60;

(5) For a comprehensive history, or a comprehensive medical examination, with medical decision making of high complexity:

(a) OMHC . $157.64;

(b) Physician . $157.64;

(c) Certified registered nurse practitioner-psychiatric . $157.64.

Md. Code Regs. 10.21.25.12

Regulation .12 adopted effective 41:2 Md. R. 91, eff.2/3/2014