Title 15. Health Insurance — Subtitle 7. Required Reimbursement for Services of Health Care Providers
Statutes in effect as of October 1, 2026.
Md. Code Ann., Ins. § 15-701 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–701LinkCopy Citation
(a)
(1)
This subsection applies to each individual or group health insurance policy, contract, or certificate that is:
(i)
delivered or issued for delivery in the State by an insurer or nonprofit health service plan; and
(ii)
issued, renewed, amended, or reissued on or after July 1, 1984.
(2)
Notwithstanding any other provision of a policy, contract, or certificate subject to this subsection, if the policy, contract, or certificate provides for reimbursement for a service that is within the lawful scope of practice of a health care provider licensed under the Health Occupations Article, the insured or any other person covered by or entitled to reimbursement under the policy, contract, or certificate is entitled to reimbursement for the service.
(b)
An individual or group disability insurance policy or contract that is delivered or issued for delivery in the State may not contain a provision that precludes a licensed health care provider from attesting to the rendition of service that is within the lawful scope of practice of the attesting provider.
Md. Code Ann., Ins. § 15-702 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–702LinkCopy Citation
(a)
This section applies to each self-funded group insurance plan that:
(1)
(i)
is formed by an order, society, or association that is incorporated or has a main office in the State; or
(ii)
covers individuals who reside or work in the State; and
(2)
is issued, renewed, amended, or reissued on or after July 1, 1972.
(b)
Notwithstanding any other provision of a self-funded group insurance plan subject to this section, if the plan provides for reimbursement for a service that is within the lawful scope of practice of a physician, dentist, or podiatrist, the plan may not prohibit a person covered by the plan from being reimbursed for the service regardless of whether the service is performed by a physician, dentist, or podiatrist.
Md. Code Ann., Ins. § 15-703 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–703LinkCopy Citation
(a)
In this section, “certified nurse practitioner” means a licensed registered nurse who has:
(1)
completed a nurse practitioner program approved by the State Board of Nursing; and
(2)
passed an examination approved by the State Board of Nursing.
(b)
Each insurer that proposes to issue, renew, amend, or reissue an individual, group, or blanket health insurance policy in the State that is written on an expense-incurred basis shall offer the option of providing benefits for expenses that arise from services rendered by a certified nurse practitioner.
(c)
Each nonprofit health service plan that proposes to issue, renew, amend, or reissue a health insurance policy in the State shall offer the option of providing benefits for expenses that arise from services rendered by a certified nurse practitioner.
(d)
The insurer or nonprofit health service plan may limit the coverage offered under this section for services provided by a certified nurse practitioner while working under the direct supervision of a physician.
(e)
The utilization of health insurance benefits provided under this section for services rendered by a certified nurse practitioner is subject to review by a peer review committee appointed by the State Board of Nursing.
Md. Code Ann., Ins. § 15-704 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–704LinkCopy Citation
(a)
This section applies to each individual, group, or blanket health insurance policy, contract, or certificate of an insurer or nonprofit health service plan that:
(1)
(i)
is delivered or issued for delivery in the State;
(ii)
is issued to a group that is incorporated or has a main office in the State; or
(iii)
covers individuals who reside or work in the State; and
(2)
is issued, renewed, amended, or reissued on or after October 1, 2003.
(b)
If a policy, contract, or certificate subject to this section provides for reimbursement for a service that is within the lawful scope of practice of a licensed clinical professional counselor, a licensed clinical marriage and family therapist, a licensed clinical alcohol and drug counselor, or a licensed clinical professional art therapist, the insured or any other person covered by the policy or certificate is entitled to reimbursement for the service.
Md. Code Ann., Ins. § 15-705 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–705LinkCopy Citation
For the purposes of a policy of health insurance or other insurance, a chiropractor is entitled to compensation for those services that the chiropractor is licensed to perform under the Health Occupations Article and that the chiropractor has rendered to an insured.
Md. Code Ann., Ins. § 15-706 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–706LinkCopy Citation
(a)
(1)
Subject to subsection (c) of this section, a policy, contract, or certificate described in § 15–701(a) of this subtitle may provide for reimbursement under § 15–701(a) of this subtitle for usual, customary, and reasonable charges for services rendered by a dietitian or nutritionist licensed under the Health Occupations Article if a licensed physician determines that the services are medically necessary for the treatment of cardiovascular disease, diabetes, prediabetes, obesity, malnutrition, cancer, cerebral vascular disease, or kidney disease.
(2)
Application of this subsection is limited to six visits with a dietitian or nutritionist during a 12–month period for each condition described in paragraph (1) of this subsection and to services for the treatment of obesity only if provided in conjunction with the treatment of a condition described in paragraph (1) of this subsection.
(b)
This section does not require a policy, contract, or certificate described in § 15–701(a) of this subtitle to provide coverage for services rendered by a nutritionist or dietitian.
(c)
If a service covered under a policy, contract, or certificate described in § 15–701(a) of this subtitle is provided to a hospital patient by a dietitian or nutritionist:
(1)
the usual, customary, and reasonable charges of the dietitian or nutritionist shall be included in the patient’s hospital charges; and
(2)
the dietitian or nutritionist may not bill the patient separately for the service.
Md. Code Ann., Ins. § 15-707 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–707LinkCopy Citation
(a)
This section applies to each individual, group, or blanket health insurance policy of an insurer or nonprofit health service plan that:
(1)
(i)
is delivered or issued for delivery in the State;
(ii)
is issued to a group that is incorporated or has a main office in the State; or
(iii)
covers individuals who reside or work in the State; and
(2)
is issued, renewed, amended, or reissued on or after January 1, 1978.
(b)
If a policy or certificate subject to this section provides for reimbursement for a service that is within the lawful scope of practice of a licensed certified social worker, the insured or any other person covered by the policy or certificate is entitled to reimbursement for the service regardless of whether the service is performed by a physician or licensed certified social worker–clinical.
Md. Code Ann., Ins. § 15-708 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–708LinkCopy Citation
(a)
In this section, “nurse anesthetist” means a registered nurse who is certified as a nurse anesthetist by:
(1)
the Council on Certification of Nurse Anesthetists; or
(2)
the Council on Recertification of Nurse Anesthetists.
(b)
This section applies to each individual, group, or blanket health insurance policy, contract, or certificate of an insurer or nonprofit health service plan that:
(1)
(i)
is issued or delivered in the State;
(ii)
is issued to a group that is incorporated or has a main office in the State; or
(iii)
covers individuals who reside or work in the State;
(2)
is issued, renewed, amended, or reissued on or after July 1, 1984; and
(3)
if issued by an insurer, is written on an expense-incurred basis.
(c)
Notwithstanding any other provision of a policy, contract, or certificate subject to this section, if the policy, contract, or certificate provides for reimbursement for a service that is within the lawful scope of practice of a nurse anesthetist, the insured or any other person covered by the policy, contract, or certificate is entitled to reimbursement for the service regardless of whether the service is performed by a physician or nurse anesthetist.
(d)
A policy that provides benefits under this section for services rendered by a nurse anesthetist may not require, as a condition for the payment of benefits, that the nurse anesthetist be employed by a physician.
(e)
The utilization of health insurance benefits provided under this section for services rendered by a nurse anesthetist is subject to review by a peer review committee appointed by the State Board of Nursing.
Md. Code Ann., Ins. § 15-709 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–709LinkCopy Citation
(a)
In this section, “nurse midwife” means a licensed registered nurse who is certified as a nurse midwife by the American College of Nurse-Midwives.
(b)
Each insurer that proposes to issue, renew, amend, or reissue an individual, group, or blanket health insurance policy in the State that is written on an expense-incurred basis shall offer the option of providing benefits for expenses that arise from services rendered by a nurse midwife.
(c)
Each nonprofit health service plan that proposes to issue, renew, amend, or reissue a health insurance policy in the State shall offer the option of providing benefits for expenses that arise from services rendered by a nurse midwife.
(d)
(1)
This subsection applies to each individual, group, or blanket health insurance policy, contract, or certificate of an insurer or nonprofit health service plan that:
(i)
(1)
is issued or delivered in the State;
(2)
is issued to a group that is incorporated or has a main office in the State; or
(3)
covers individuals who reside or work in the State;
(ii)
is issued, renewed, amended, or reissued on or after July 1, 1979; and
(iii)
if issued by an insurer, is written on an expense-incurred basis.
(2)
Notwithstanding any other provision of a policy, contract, or certificate subject to this subsection, if the policy, contract, or certificate provides for reimbursement for a service that is within the lawful scope of practice of a nurse midwife, the insured or any other person covered by the policy, contract, or certificate is entitled to reimbursement for the service regardless of whether the service is performed by a physician or nurse midwife.
(e)
A policy that provides benefits under this section for services rendered by a nurse midwife may not require, as a condition for the payment of benefits, that the nurse midwife be employed by a physician or act under a physician’s orders.
(f)
The utilization of health insurance benefits provided under this section for services rendered by a nurse midwife is subject to review by a peer review committee appointed by the State Board of Nursing.
Md. Code Ann., Ins. § 15-710 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–710LinkCopy Citation
(a)
This section applies to each individual or group health insurance policy or certificate of an insurer that:
(1)
is issued or delivered in the State;
(2)
is issued to a group that is incorporated or has a main office in the State; or
(3)
covers individuals who reside or work in the State.
(b)
Each policy or certificate subject to this section that provides for reimbursement for a service that is within the lawful scope of practice of an optometrist licensed under the Health Occupations Article shall require the insurer to reimburse the insured or any other person covered by the policy or certificate for the service performed by the optometrist in accordance with the other provisions of the policy or certificate.
Md. Code Ann., Ins. § 15-711 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–711LinkCopy Citation
(a)
This section applies to each individual or group health insurance policy or contract that is:
(1)
delivered or issued for delivery in the State by an insurer or nonprofit health service plan; and
(2)
issued, renewed, amended, or reissued on or after October 1, 1993.
(b)
An insurer or nonprofit health service plan may not impose a time limit on the receipt of services covered under a policy or contract subject to this section that are provided during the policy or contract period by a physical therapist licensed under the Health Occupations Article.
(c)
This section does not prohibit an insurer or nonprofit health service plan from imposing a limit on the number of visits with a licensed physical therapist that are allowed under a policy or contract.
Md. Code Ann., Ins. § 15-712 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–712LinkCopy Citation
Notwithstanding § 15-701(a) of this subtitle, unless a policy, contract, or certificate described in § 15-701(a) of this subtitle expressly provides for reimbursement for a service that is within the lawful scope of practice of a physician assistant certified under the Health Occupations Article, the provisions of the Health Occupations Article that govern the certification and regulation of physician assistants may not be construed to entitle the insured or any other person covered by the policy, contract, or certificate to reimbursement for the service.
Md. Code Ann., Ins. § 15-713 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–713LinkCopy Citation
(a)
This section applies to individual, group, or blanket health insurance policies and contracts delivered or issued for delivery in the State by insurers, nonprofit health service plans, and health maintenance organizations.
(b)
Notwithstanding any other provision of an individual, group, or blanket health insurance policy or contract subject to this section, if the policy or contract provides for reimbursement for a service that is within the lawful scope of practice of a licensed podiatrist, the insured or any other person covered by or entitled to reimbursement under the policy or contract is entitled to the same amount of reimbursement for the service regardless of whether the service is performed by a physician or licensed podiatrist.
(c)
This section does not prohibit, and may not be construed as prohibiting, the determination of reimbursement based on the geographic location of the delivery of service, the preeminent qualifications of a physician or podiatrist, or the need to provide services in an underserved area of the State.
Md. Code Ann., Ins. § 15-714 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–714LinkCopy Citation
(a)
This section applies to each individual or group health insurance policy, contract, or certificate that:
(1)
(i)
is issued or delivered in the State;
(ii)
is issued to a group that is incorporated or has a main office in the State; or
(iii)
covers individuals who reside or work in the State; and
(2)
is issued, renewed, amended, or reissued on or after July 1, 1972.
(b)
Notwithstanding any other provision of a policy, contract, or certificate subject to this section, if the policy, contract, or certificate provides for reimbursement for a service that is within the lawful scope of practice of a licensed psychologist, the insured or any other person covered by the policy, contract, or certificate is entitled to reimbursement for the service regardless of whether the service is performed by a physician or licensed psychologist.
Md. Code Ann., Ins. § 15-715 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–715LinkCopy Citation
(a)
This section applies to each individual or group health insurance policy or contract that is issued or delivered in the State by an insurer, nonprofit health service plan, or health maintenance organization.
(b)
To the extent required under federal law, an insurer, nonprofit health service plan, or health maintenance organization shall reimburse a community health resource, as defined in § 19-2101 of the Health - General Article, for covered services provided to the insured or any other person covered by the policy or contract.
Md. Code Ann., Ins. § 15-716 (2026)
Title 15. Health Insurance
Subtitle 7. Required Reimbursement for Services of Health Care Providers
§ 15–716LinkCopy Citation
(a)
This section applies to individual, group, or blanket health insurance policies and contracts delivered or issued for delivery in the State by insurers, nonprofit health service plans, and health maintenance organizations that provide coverage for services that are within the lawful scope of practice of a licensed pharmacist.
(b)
An entity subject to this section shall provide coverage for services rendered by a licensed pharmacist acting within the pharmacist’s lawful scope of practice to an individual who is covered under a policy or contract issued or delivered by the entity, to the same extent as services rendered by any other licensed health care practitioner.
(c)
Reimbursement for services provided under this section may not be conditioned on whether the licensed pharmacist is:
(1)
employed by a physician, pharmacy, or facility; or
(2)
acting under a physician’s orders.