# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 50 — EPSDT School Health-Related Services or Health-Related Early Intervention Services

#### Regulation .05 Limitations.

*COMAR 10.09.50.05*

A. To participate in the Program as a provider of health-related services or health-related early intervention services, the provider shall be a local school system, a local lead agency, a State-operated education agency, or State-supported education agency.

B. Health-related services or health-related early intervention services outlined in the IEP or the IFSP shall be approved by the IEP or IFSP team for continued treatment.

C. Therapeutic behavioral services may only be provided if:

  (1) Preauthorized through the IEP or IFSP process and directly related to the IEP or IFSP;

  (2) Services are not custodial;

  (3) Services are considered medically necessary by the IEP or IFSP team, which develops the recipient’s IEP or IFSP;

  (4) Delivered in the recipient's home, school, or other setting if normal activities are disrupted;

  (5) The therapeutic behavioral aide is not a member of the recipient's immediate family or an individual who ordinarily resides in the recipient's home; and

  (6) The recipient has:

    (a) Maladaptive behavior;

    (b) Warrants a behavioral plan;

    (c) Behavior that is deviant from developmentally appropriate behavior for the individual’s chronological age as determined by the IEP or IFSP team;

    (d) A behavior plan that does not include aversive techniques, restraints, and seclusion, or any of these; and

    (e) No insurance coverage for therapeutic behavior services when compensated as an individual service covered by another third party insurance or part of a package of benefits covered by either another third party insurance or another public agency.