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<regulation prefix="Regulation" num=".08" citation="COMAR 10.09.48.08" title_num="10" subtitle_num="09" chapter_num="48" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Request for Payment.</text>
    <paragraph num="(1)">
      <text>Requests for payment for the services covered under this chapter shall be submitted by a provider according to procedures set forth in COMAR 10.09.36.04.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Billing time limitations for services covered under this chapter are the same as those set forth in COMAR 10.09.36.06.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Payment Rates.</text>
    <paragraph num="(1)">
      <text>The Department shall publish a fee schedule for services covered under this chapter, which shall be publicly available and updated at least annually or upon any changes made by the Department.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Department's rates set forth in its fee schedule will apply to services covered under this chapter that are provided under either the traditional services delivery model or the self-directed services delivery model.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The Program's rates for covered services under this chapter shall increase on July 1 of each year, subject to the limitations of the State budget.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Providers shall be reimbursed within 45 business days of approved invoice for services rendered based on the rates set forth in §C(1) and (2) of this regulation.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>For a comprehensive assessment, providers shall be reimbursed $450 per assessment.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>For all other services rendered to Maryland Medicaid participants residing in counties other than those listed in §B(7) of this regulation, providers shall be reimbursed:</text>
      <paragraph num="(a)">
        <text>For dates of service January 1, 2023 through June 30, 2023, $24.56 per unit;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For dates of service July 1, 2023 through December 31, 2023, $25.54 per unit;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>For dates of service January 1, 2024 through June 30, 2024, $27.50 per unit; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>For dates of service July 1, 2024 through June 30, 2025, $28.33 per unit.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Providers rendering services to Maryland Medicaid participants residing in Calvert, Charles, Frederick, Montgomery, and Prince George’s counties shall be reimbursed:</text>
      <paragraph num="(a)">
        <text>For dates of service January 1, 2023 through June 30, 2023, $25.86 per unit;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For dates of service July 1, 2023 through December 31, 2023, $26.89 per unit;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>For dates of service January 1, 2024 through June 30, 2024, $28.96 per unit; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>For dates of service July 1, 2024 through June 30, 2025, $29.83 per unit.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Changes in Rates.</text>
    <paragraph num="(1)">
      <text>The rates are subject to the limitations of the State budget.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Unless otherwise authorized, the rates may be changed on July 1 of each year beginning July 1, 2015, based on legislative action, and subject to limitations of the State budget.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Payment Limitations.</text>
    <paragraph num="(1)">
      <text>Payment shall be made only to one provider for covered services rendered to a participant on a particular date of service.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Payment for the services covered under this chapter:</text>
      <paragraph num="(a)">
        <text>Shall be considered as payment in full; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>May not supplement or be supplemented by payment from other sources, such as the participant, family, a public program, or private agency.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>For a comprehensive assessment, only one assessment may be reimbursed per participant, unless otherwise authorized by DDA.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Ongoing coordination of community services shall be billed on a scheduled determined by the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Units of Services and Limitations.</text>
    <paragraph num="(1)">
      <text>All coordination of community services other than the initial comprehensive assessment shall be billed to DDA in units of service.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>DDA shall provide payment for only those coordination of community services that were authorized by DDA before the provision of the service.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Each fiscal year, the coordinator of community services shall complete the core services for each participant.</text>
    </paragraph>
  </paragraph>
</regulation>