Regulation .08 Recovery and Reimbursement.
Regulation .08 Recovery and Reimbursement.LinkCopy Citation
A.
Regardless of whether the participant has other third-party insurance coverage, EPSDT screening providers shall bill the Program directly for the following components of an EPSDT screen:
(1)
Comprehensive unclothed physical examinations;
(2)
Immunizations when the vaccine is not covered by the Vaccines for Children Program;
(3)
Vaccine administration; and
(4)
Objective screenings for:
(a)
Developmental assessment;
(b)
Hearing; and
(c)
Vision.
B.
Upon submission of a claim for a EPSDT screening component, as described in §A of this regulation, the Department shall pursue third-party reimbursement when appropriate.
C.
Recovery and reimbursement for all other services in the chapter are set forth in COMAR 10.09.36.07.