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<regulation prefix="Regulation" num=".02" citation="COMAR 10.09.49.02" title_num="10" subtitle_num="09" chapter_num="49" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Administrative services organization (ASO)” means an entity that manages the Public Behavioral Health System on behalf of the Department.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Department” means the Maryland Department of Health, which is the single State agency designated to administer the Medical Assistance Program under Title XIX of the Social Security Act, 42 U.S.C. §1396 et seq.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Distant site” means a site at which the licensed, certified, or otherwise authorized distant site provider is located at the time the service is provided via technology-assisted communication.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Distant site provider” means the licensed, certified, or otherwise authorized provider at the distant site who provides medically necessary services via telehealth to the patient.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“GT modifier” means the Healthcare Common Procedure Coding System service code modifier indicating that the provider rendered a healthcare service via an interactive audio and video telecommunications system.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Medically necessary" means that the service or benefit is:</text>
      <paragraph num="(a)">
        <text>Directly related to diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative treatment of an illness, injury, disability, or health condition;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Consistent with currently accepted standards of good medical practice;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The most cost-efficient service that can be provided without sacrificing effectiveness or access to care; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Not primarily for the convenience of the participant, family, or provider.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>“Originating site means the location of an eligible Medicaid participant at the time the service being furnished via technology-assisted communication occurs.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Participant” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Provider” means:</text>
      <paragraph num="(a)">
        <text>An individual, association, partnership, corporation, unincorporated group, or any other person authorized, licensed, or certified to provide services for Medical Assistance participants and who, through appropriate agreement with the Department, has been identified as a Maryland Medical Assistance Provider by the issuance of an individual account number;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>An agent, employee, or related party of a person identified in §B(12)(a) of this regulation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An individual or any other person with an ownership interest in a person identified in §B(12)(a) of this regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Store and Forward Technology.</text>
      <paragraph num="(a)">
        <text>“Store and forward technology" means the transmission of medical images or other media captured by the originating site provider and sent electronically to a distant site provider, who does not physically interact with the patient located at the originating site.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Store and forward technology” does not mean dermatology, ophthalmology, or radiology services according to COMAR 10.09.02.07.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>“Technology-assisted communication” means multimedia communication equipment permitting two-way real-time interactive communication between a patient at an originating site and a distant site provider at a distant site.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Telehealth” means the synchronous delivery of medically necessary services to a patient at an originating site by distant site provider, through the use of technology-assisted communication.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Telehealth Program” means the program by which medically necessary services are authorized to be delivered via technology-assisted communication between originating and distant site providers.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“UB modifier” means the Healthcare Common Procedure Coding System service code modifier indicating that the provider rendered a healthcare service via an interactive audio-only telecommunications system.</text>
    </paragraph>
  </paragraph>
</regulation>