# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 18 — Oxygen and Related Respiratory Equipment Services

#### Regulation .05 Limitations.

*COMAR 10.09.18.05*

A. The Program does not cover:

  (1) Any service or items not identified in Regulation .04 of this chapter;

  (2) Demurrage;

  (3) Charges for delivery;

  (4) Equipment prescribed primarily to provide comfort or convenience, including, but not limited to, air conditioners and room humidifiers;

  (5) Items which are investigational or experimental in nature;

  (6) Oxygen and related equipment not for pulmonary use;

  (7) Pre-set oxygen for emergency use;

  (8) Trach string or tape.

B. The Program places the following limitations upon covered services:

  (1) Reimbursement for aerosol equipment will only be provided if a hand held nebulizer has been tried and is not successful, as indicated in the clinical summary;

  (2) Reimbursement for IPPB machine will only be authorized if the aerosol compressor with the nebulizer kit has been tried and is not successful, as indicated in the clinical summary;

  (3) Reimbursement may not be made for:

    (a) Repairs or replacement parts for rented items;

    (b) Oxygen prescribed on an as-needed basis (PRN);

    (c) Oxygen prescribed for stand-by purposes;

    (d) Piped-in oxygen;

    (e) Oxygen and related respiratory equipment and services provided in a facility or by a group when reimbursement is covered by another segment of the Program; and

  (4) Payment for portable oxygen will be made only when:

    (a) It is required in the pursuit of medical treatment; and

    (b) The medical necessity is indicated for this type of system.