# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 01 — Advanced Practice Nurse Services

#### Regulation .05 Limitations.

*COMAR 10.09.01.05*

Under this chapter, the Program does not cover the following:

A. Services not medically necessary;

B. Services prohibited by the Maryland Nurse Practice Act or by the Board;

C. Advanced practice nursing services included as part of the cost of:

  (1) An inpatient facility;

  (2) A hospital outpatient department; or

  (3) A freestanding clinic;

D. Visits by or to the provider solely for the purpose of the following:

  (1) Prescription, drug, or food supplement pick-up;

  (2) Recording of an electrocardiogram;

  (3) Ascertaining the patient’s weight;

  (4) Interpretation of laboratory tests or panels; or

  (5) Prescribing or administering medication;

E. Drugs and supplies which are acquired by the provider at no cost;

F. Injections and visits solely for the administration of injections, unless medical necessity and the patient's inability to take oral medications are documented in the patient's medical record;

G. Services paid under the free-standing dialysis program as described in COMAR 10.09.22;

H. Immunizations required for travel outside the continental United States;

I. Prescriptions and injections for central nervous system stimulants and anorectic agents when used for weight control;

J. Acupuncture;

K. Hypnosis;

L. Travel expenses;

M. Investigational or experimental drugs and procedures;

N. Services denied by Medicare as not medically justified;

O. Specimen collection, except by venipuncture and capillary or arterial puncture, as a separate service;

P. Laboratory or X-ray services performed by another facility, which shall be billed to the Program directly by the facility; and

Q. For certified nurse midwives, a separate visit charge on date of delivery.