# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 22 — Free-Standing Dialysis Facility Services

#### Regulation .04 Covered Services.

*COMAR 10.09.22.04*

A. The Program covers medically necessary services described in §B of this regulation, rendered to participants in a free-standing dialysis facility, when these services are:

  (1) Performed by a physician or by one of the following:

    (a) A physician assistant;

    (b) A nurse practitioner;

    (c) An RN;

    (d) An LPN;

    (e) A social worker; or

    (f) A dietitian-nutritionist;

  (2) Provided by a non-physician listed in §A(1) of this regulation, when the following conditions are met:

    (a) The individual performing the service is in the employ of, or under contract with, the free-standing dialysis facility;

    (b) The individual performing the service is under a physician's direct supervision or written direction;

    (c) The individual performs the service within the scope of the individual's license or certification for the purpose of assisting in the provision of the physician's services; and

    (d) The services are provided according to the free-standing dialysis facility physician's written plan of care;

  (3) Curative or rehabilitative services, when clearly related to the participant’s individual needs;

  (4) Adequately described in the participant’s medical record and consistent with the physician’s written plan of care.

B. Covered services include:

  (1) Dialysis services furnished on an outpatient basis and provided by a free-standing dialysis facility, to include hemodialysis, peritoneal dialysis, CAPD, CCPD, and home dialysis training; and

  (2) Laboratory tests, supplies, and prescription drugs as related to dialysis services.