<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.09.49.09" title_num="10" subtitle_num="09" chapter_num="49" heading="Limitations.">
  <paragraph num="A.">
    <text>A service provided through telehealth is subject to the same program restrictions, preauthorizations, limitations, and coverage that exist for the service when provided in person.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A telehealth service does not include:</text>
    <paragraph num="(1)">
      <text>An audio-only telephone conversation between a health care provider and a patient;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An electronic mail message between a health care provider and a patient;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A facsimile transmission between a health care provider and a patient; or</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A telephone conversation, electronic mail message, or facsimile transmission between the originating and distant site providers without interaction between the distant site provider and the patient.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Store and forward technology does not meet the Maryland Medical Assistance Program’s definition of telehealth. The Maryland Medical Assistance Program covers services such as dermatology, ophthalmology, and radiology according to COMAR 10.09.02.07.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Telehealth-delivered services may not bill to the Maryland Medical Assistance Program or to the ASO when technical difficulties preclude the delivery of part or all of the telehealth session.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The Department may not reimburse a provider for the following:</text>
    <paragraph num="(1)">
      <text>Services that occur during an ambulance transport;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Communications between providers where the participant is not physically present at the originating site;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Telehealth services delivered where the originating site is not a permitted originating site provider as set forth in Regulation .06 of this chapter; or</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Mental health and substance use disorder services that did not receive prior authorization from the Department or its ASO.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>The Department may not reimburse for services that:</text>
    <paragraph num="(1)">
      <text>Require in-person evaluation; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Cannot be reasonably delivered via telehealth.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>The Department may not reimburse distant site providers for a facility fee.</text>
  </paragraph>
  <paragraph num="H.">
    <text>The Department may not reimburse for home health monitoring services.</text>
  </paragraph>
</regulation>