# 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 .07 Payment Procedures.

*COMAR 10.09.50.07*

A. Request for Payment.

  (1) An approved provider shall submit a request for payment of services rendered and completed under this chapter as set forth in COMAR 10.09.36.04. The Department reserves the right to return to the provider, before payment, all payment requests not properly prepared or submitted.

  (2) A provider shall submit a request for payment as set forth in COMAR 10.09.36.04A. The completed form shall indicate the:

    (a) Date or dates of service;

    (b) Participant's name and Medical Assistance number;

    (c) Provider's name, location, and provider number; and

    (d) Nature, unit or units, and procedure code or codes of covered services provided.

B. Providers may not bill the Program for:

  (1) Services not rendered in person, unless the services are provided in compliance with COMAR 10.09.49 and any guidance issued by the Department:

  (2) Completion of forms or reports;

  (3) Broken or missed appointments;

  (4) Services which duplicate a service that a recipient is receiving under another medical care program.

C. The Program may not make direct payment to a participant.

D. Billing time limitations for services covered under this chapter are the same as those set forth in COMAR 10.09.36.06.

E. Reimbursement for health-related services and health-related early intervention services is contained in COMAR 10.09.02.07D. The State portion of reimbursement is provided by the Maryland State Department of Education.

F. Psychological services not delivered in accordance with an IEP or IFSP are reimbursable when they are:

  (1) Rendered by a school psychologist or school social worker that:

    (a) Meets the qualifications of this chapter; and

    (b) Is enrolled with the Medicaid Program in accordance with COMAR 10.09.36; and

  (2) Billed by a local education agency in accordance with COMAR 10.09.59.09.