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<regulation prefix="Regulation" num=".04" citation="COMAR 10.09.10.04" title_num="10" subtitle_num="09" chapter_num="10" heading="Covered Services.">
  <text>The Program covers routine care and the following supplies, equipment, and services when appropriate to meet the needs of the recipient:</text>
  <paragraph num="A.">
    <text>Those described in the Maryland Department of Health regulations entitled “Requirements for Long Term Care Facilities”, 42 CFR Part 483, Subpart B (1996), subject to limitations in Regulation .05 of this chapter.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Over-the-counter drugs.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Bed reservations for recipients who are on a leave of absence to visit with friends or relatives or to participate in State-approved therapeutic or rehabilitative programs for a maximum of 18 days in any calendar year and without any limitation on the number of days per visit.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Repealed.</text>
  </paragraph>
  <paragraph num="E.">
    <text>Administrative days approved by the Department or its designee according to the conditions set forth in Regulation .26D of this chapter.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Specialized rehabilitative therapy services which meet the conditions listed below:</text>
    <paragraph num="(1)">
      <text>Physical Therapy. Physical therapy services for Medical Assistance Program purposes are those services furnished to a recipient which meet all of the following conditions:</text>
      <paragraph num="(a)">
        <text>The services are directly and specifically related to a plan of care designed by the physician after any needed consultation with the qualified physical therapist;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The services are of such a level of complexity and sophistication or the condition of the recipient needs the judgment, knowledge, or skills of a qualified physical therapist;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The services are performed by or under the supervision of a qualified physical therapist;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The services are provided with the expectation, based on the assessment made by the physician of the recipient's restorative potential after any needed consultation with the qualified physical therapist, that the recipient will improve significantly in a reasonable, and generally predictable, period of time;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The services are considered under accepted standards of medical practice to be a specific and effective treatment for the recipient's condition; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The services are reasonable and necessary to the treatment of the recipient's condition.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Occupational Therapy. Occupational therapy services for Medical Assistance Program purposes are those which meet the following conditions:</text>
      <paragraph num="(a)">
        <text>The services are directly and specifically related to a plan of care designed by the physician after any needed consultation with the qualified occupational therapist;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The services are on a level of complexity and sophistication or the condition of the recipient needs the judgment, knowledge, and skills of a qualified occupational therapist;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The services are performed by a qualified occupational therapist;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The services are for the purposes of improving or restoring functions which have been impaired by illness or injury or, if function has been permanently lost or reduced by illness or injury, to improve the individual's ability to perform those tasks required for independent functioning;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The services are considered under accepted standards of medical practice to be a specific and effective treatment for the recipient's condition; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The services are reasonable and necessary to the treatment of the recipient's condition.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Speech Therapy. Speech therapy services for Medical Assistance Program purposes are those services furnished to a recipient which meet all of the following conditions:</text>
      <paragraph num="(a)">
        <text>The services are directly and specifically related to a plan of care designed by the physician after any needed consultation with the qualified speech and language pathologist;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The services are of such a level of complexity and sophistication or the condition of the recipient needs the judgment, knowledge, and skills of a qualified speech and language pathologist;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The services are performed by or under the supervision of a qualified speech and language pathologist;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The services are provided with the expectation, based on the assessment made by the physician of the recipient's restorative potential after any needed consultation with the qualified speech and language pathologist, that the recipient will improve significantly in a reasonable, and generally predictable, period of time;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The services are considered under accepted standards of medical practice to be a specific and effective treatment for the recipient's condition; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The services are reasonable and necessary to the treatment of the recipient's condition.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Supplies and equipment necessary to meet the needs of the recipient, including but not limited to:</text>
    <paragraph num="(1)">
      <text>ABD pads.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Adhesive strip bandages.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Adhesive tape (regular and non-allergenic).</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Airways — oral and nasal.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Alcohol and alcohol sponges.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Ambu bags.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Antiseptics and cleansing agents (over-the-counter).</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Applicators.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Bandages.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Beds, high-low, adjustable.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Bed pans and urinals.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Bed rails.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Bibs.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Body lotions (over-the-counter).</text>
    </paragraph>
    <paragraph num="(15)">
      <text>Canes.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>Catheters (including Foley or other indwelling).</text>
    </paragraph>
    <paragraph num="(17)">
      <text>Catheter trays.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>Chest or body restraints.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>Clean catch kits.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>Clinical medicine glasses — disposable or otherwise.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>Cotton and cotton balls.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>Covered water pitchers.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>Crutches.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>Dentifrices and denture adhesives.</text>
    </paragraph>
    <paragraph num="(25)">
      <text>Denture cups.</text>
    </paragraph>
    <paragraph num="(26)">
      <text>Deodorant (personal and room).</text>
    </paragraph>
    <paragraph num="(27)">
      <text>Diagnostic aids (Clinitest, Acetest, Hematest, Testape, etc.).</text>
    </paragraph>
    <paragraph num="(28)">
      <text>Dietary supplements (including tube feeding).</text>
    </paragraph>
    <paragraph num="(29)">
      <text>Disposable diapers or incontinency care pads.</text>
    </paragraph>
    <paragraph num="(30)">
      <text>Disposable wash cloths.</text>
    </paragraph>
    <paragraph num="(31)">
      <text>Douche apparatus.</text>
    </paragraph>
    <paragraph num="(32)">
      <text>Drainage bags and catheter tubing.</text>
    </paragraph>
    <paragraph num="(33)">
      <text>Emesis basins.</text>
    </paragraph>
    <paragraph num="(34)">
      <text>Enema apparatus.</text>
    </paragraph>
    <paragraph num="(35)">
      <text>Enemas and douches (including prepared).</text>
    </paragraph>
    <paragraph num="(36)">
      <text>Eye pads.</text>
    </paragraph>
    <paragraph num="(37)">
      <text>First aid supplies.</text>
    </paragraph>
    <paragraph num="(38)">
      <text>Gauzes.</text>
    </paragraph>
    <paragraph num="(39)">
      <text>Hot water bottles and covers.</text>
    </paragraph>
    <paragraph num="(40)">
      <text>Hydraulic lifts.</text>
    </paragraph>
    <paragraph num="(41)">
      <text>Ice bags.</text>
    </paragraph>
    <paragraph num="(42)">
      <text>Infusionarm boards.</text>
    </paragraph>
    <paragraph num="(43)">
      <text>Intermittent positive pressure breathing machines (I.P.P.B.).</text>
    </paragraph>
    <paragraph num="(44)">
      <text>Intravenous poles, portable.</text>
    </paragraph>
    <paragraph num="(45)">
      <text>Irrigation trays.</text>
    </paragraph>
    <paragraph num="(46)">
      <text>Levine tubes (plastic or regular).</text>
    </paragraph>
    <paragraph num="(47)">
      <text>Lubricants and oils.</text>
    </paragraph>
    <paragraph num="(48)">
      <text>Mouth washes.</text>
    </paragraph>
    <paragraph num="(49)">
      <text>Nasal atomizers.</text>
    </paragraph>
    <paragraph num="(50)">
      <text>Needles (cardiac, clysis or intravenous, permanent or disposable).</text>
    </paragraph>
    <paragraph num="(51)">
      <text>Oxygen for occasional and emergency use. Continuous oxygen is covered under the provisions of COMAR 10.09.18 Oxygen and Related Respiratory Equipment Services.</text>
    </paragraph>
    <paragraph num="(52)">
      <text>Oxygen masks, cannulas, catheters, and related equipment, including portable equipment for use with occasional or emergency oxygen. Equipment used for continuous use oxygen is covered under the provision of COMAR 10.09.18 Oxygen and Related Respiratory Equipment Services.</text>
    </paragraph>
    <paragraph num="(53)">
      <text>Paper tissues.</text>
    </paragraph>
    <paragraph num="(54)">
      <text>Personal toilet items (toothbrush, soap, shampoo, razor, shaving cream, sanitary pads).</text>
    </paragraph>
    <paragraph num="(55)">
      <text>Petroleum jelly.</text>
    </paragraph>
    <paragraph num="(56)">
      <text>Powder, medicated or non-medicated—over-the-counter.</text>
    </paragraph>
    <paragraph num="(57)">
      <text>Pumps, aspiration and suction.</text>
    </paragraph>
    <paragraph num="(58)">
      <text>Rectal tubes.</text>
    </paragraph>
    <paragraph num="(59)">
      <text>Rubber or plastic gloves and finger cots.</text>
    </paragraph>
    <paragraph num="(60)">
      <text>Rubber or plastic pants.</text>
    </paragraph>
    <paragraph num="(61)">
      <text>Rubber or plastic sheeting.</text>
    </paragraph>
    <paragraph num="(62)">
      <text>Rubber or sponge rings.</text>
    </paragraph>
    <paragraph num="(63)">
      <text>Sand bags.</text>
    </paragraph>
    <paragraph num="(64)">
      <text>Scales, including chair scales.</text>
    </paragraph>
    <paragraph num="(65)">
      <text>Sheepskin, natural or synthetic.</text>
    </paragraph>
    <paragraph num="(66)">
      <text>Slings.</text>
    </paragraph>
    <paragraph num="(67)">
      <text>Special mattresses for decubiti care.</text>
    </paragraph>
    <paragraph num="(68)">
      <text>Sphygmomanometers.</text>
    </paragraph>
    <paragraph num="(69)">
      <text>Stethoscopes.</text>
    </paragraph>
    <paragraph num="(70)">
      <text>Stryker and Foster frames.</text>
    </paragraph>
    <paragraph num="(71)">
      <text>Suction machines, gastric and tracheal.</text>
    </paragraph>
    <paragraph num="(72)">
      <text>Suction tubing.</text>
    </paragraph>
    <paragraph num="(73)">
      <text>Surgical dressings, including sterile sponges.</text>
    </paragraph>
    <paragraph num="(74)">
      <text>Suture removal kits.</text>
    </paragraph>
    <paragraph num="(75)">
      <text>Suture trays.</text>
    </paragraph>
    <paragraph num="(76)">
      <text>Syringes, plastic, glass, or bulb.</text>
    </paragraph>
    <paragraph num="(77)">
      <text>Tape removers.</text>
    </paragraph>
    <paragraph num="(78)">
      <text>Thermometers, oral, rectal, universal, bath.</text>
    </paragraph>
    <paragraph num="(79)">
      <text>Tongue depressors.</text>
    </paragraph>
    <paragraph num="(80)">
      <text>Tracheostomy equipment and supplies.</text>
    </paragraph>
    <paragraph num="(81)">
      <text>Traction equipment.</text>
    </paragraph>
    <paragraph num="(82)">
      <text>Trapeze and bed frame equipment.</text>
    </paragraph>
    <paragraph num="(83)">
      <text>Trays, cut-down.</text>
    </paragraph>
    <paragraph num="(84)">
      <text>Tubing.</text>
    </paragraph>
    <paragraph num="(85)">
      <text>Walkers and walkerettes.</text>
    </paragraph>
    <paragraph num="(86)">
      <text>Wheel chairs.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Administration of enemas.</text>
  </paragraph>
  <paragraph num="I.">
    <text>Administration of oxygen.</text>
  </paragraph>
  <paragraph num="J.">
    <text>Back rubs.</text>
  </paragraph>
  <paragraph num="K.">
    <text>Decubiti care and over-the-counter medication.</text>
  </paragraph>
  <paragraph num="L.">
    <text>Colostomy, ileostomy, and nephrostomy care.</text>
  </paragraph>
  <paragraph num="M.">
    <text>Hand feeding or self-help eating devices.</text>
  </paragraph>
  <paragraph num="N.">
    <text>Incontinency care.</text>
  </paragraph>
  <paragraph num="O.">
    <text>Personal laundry.</text>
  </paragraph>
  <paragraph num="P.">
    <text>Personal toilet (routine shaving, hair washing and arranging, routine toenail clipping, adequate bathing).</text>
  </paragraph>
  <paragraph num="Q.">
    <text>Private room for isolation purposes.</text>
  </paragraph>
  <paragraph num="R.">
    <text>Special diets, including diabetic.</text>
  </paragraph>
  <paragraph num="S.">
    <text>Tray service.</text>
  </paragraph>
  <paragraph num="T.">
    <text>Tube feeding.</text>
  </paragraph>
  <paragraph num="U.">
    <text>Portable X-ray services.</text>
  </paragraph>
  <paragraph num="V.">
    <text>Respirator management in licensed comprehensive care beds which have been determined by the Department to meet the standards for respiratory care units under COMAR 10.07.02.</text>
  </paragraph>
  <paragraph num="W.">
    <text>Intravenous therapy and venipuncture.</text>
  </paragraph>
  <paragraph num="X.">
    <text>Noninvasive traction apparatus services (cervical, Buck's extension, pelvic).</text>
  </paragraph>
  <paragraph num="Y.">
    <text>Emergency resuscitation procedures, including coronary pulmonary procedures.</text>
  </paragraph>
  <paragraph num="Z.">
    <text>Restorative nursing care.</text>
  </paragraph>
  <paragraph num="AA.">
    <text>Physician-ordered physical restraints and protective devices.</text>
  </paragraph>
  <paragraph num="BB.">
    <text>Negative pressure wound therapy.</text>
  </paragraph>
</regulation>