<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.50.07" title_num="10" subtitle_num="09" chapter_num="50" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Request for Payment.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A provider shall submit a request for payment as set forth in COMAR 10.09.36.04A. The completed form shall indicate the:</text>
      <paragraph num="(a)">
        <text>Date or dates of service;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Participant's name and Medical Assistance number;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Provider's name, location, and provider number; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Nature, unit or units, and procedure code or codes of covered services provided.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Providers may not bill the Program for:</text>
    <paragraph num="(1)">
      <text>Services not rendered in person, unless the services are provided in compliance with COMAR 10.09.49 and any guidance issued by the Department:</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Completion of forms or reports;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Broken or missed appointments;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Services which duplicate a service that a recipient is receiving under another medical care program.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The Program may not make direct payment to a participant.</text>
  </paragraph>
  <paragraph num="D.">
    <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 num="E.">
    <text>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.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Psychological services not delivered in accordance with an IEP or IFSP are reimbursable when they are:</text>
    <paragraph num="(1)">
      <text>Rendered by a school psychologist or school social worker that:</text>
      <paragraph num="(a)">
        <text>Meets the qualifications of this chapter; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is enrolled with the Medicaid Program in accordance with COMAR 10.09.36; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Billed by a local education agency in accordance with COMAR 10.09.59.09.</text>
    </paragraph>
  </paragraph>
</regulation>