<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.53.07" title_num="10" subtitle_num="09" chapter_num="53" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Payment procedures are as set forth in COMAR 10.09.36.04 and .06.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Payments.</text>
    <paragraph num="(1)">
      <text>Payments shall be made directly to a qualified provider.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>To receive payment for services under Regulation .04 of this chapter, a provider and its workers shall use the electronic visit verification method and data management system approved by the Department to document time and submit claims in accordance with COMAR 10.09.36.03-2.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Providers shall be paid the lesser of:</text>
      <paragraph num="(a)">
        <text>The provider’s customary charge to the general public unless the service is free to individuals not covered by Medicaid; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The rate established according to the fee schedule published by the Department.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Rates.</text>
    <paragraph num="(1)">
      <text>Effective July 1, 2022, through December 31, 2023, rates for the services outlined in this regulation shall be as follows:</text>
      <paragraph num="(a)">
        <text>$17.87 for 15 minutes of services provided by a registered nurse to one participant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$12.32 for 15 minutes of services provided by a registered nurse to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$11.58 for 15 minutes of services provided by a licensed practical nurse to one participant;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>$7.99 for 15 minutes of services provided by a licensed practical nurse to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>$6.12 for 15 minutes of services provided by a CNA or HHA who is also certified as a CMT to one participant;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>$4.22 for 15 minutes of services provided by a CNA or HHA who is also certified as a CMT to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>$5.08 for 15 minutes of services provided by a CNA or HHA to one participant;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>$3.50 for 15 minutes of services provided by a CNA or HHA to two or more participants in the same residence; and</text>
      </paragraph>
      <paragraph num="(i)">
        <text>A flat rate of  $71.41 per visit for a registered nurse supervisory visit of a nurse, CNA, or HHA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Effective January 1, 2024 through June 30, 2024, rates for the services outlined in this regulation shall be as follows:</text>
      <paragraph num="(a)">
        <text>$19.2951 for 15 minutes of services provided by a registered nurse to one participant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$13.3101 for 15 minutes of services provided by a registered nurse to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$12.5061 for 15 minutes of services provided by a licensed practical nurse to one participant;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>$8.6266 for 15 minutes of services provided by a licensed practical nurse to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>$6.6105 for 15 minutes of services provided by a CNA or HHA who is also certified as a CMT to one participant;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>$4.5611 for 15 minutes of services provided by a CNA or HHA who is also certified as a CMT to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>$5.4874 for 15 minutes of services provided by a CNA or HHA to one participant;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>$3.7848 for 15 minutes of services provided by a CNA or HHA to two or more participants in the same residence; and</text>
      </paragraph>
      <paragraph num="(i)">
        <text>A flat rate of $77.13 per visit for a registered nurse supervisory visit of a nurse, CNA, or HHA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Effective July 1, 2024, rates for the services outlined in this regulation shall be as follows:</text>
      <paragraph num="(a)">
        <text>$19.8739 for 15 minutes of services provided by a registered nurse to one participant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$13.7094 for 15 minutes of services provided by a registered nurse to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$12.8813 for 15 minutes of services provided by a licensed practical nurse to one participant;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>$8.8854 for 15 minutes of services provided by a licensed practical nurse to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>$6.8088 for 15 minutes of services provided by a CNA or HHA who is also certified as a CMT to one participant;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>$4.6979 for 15 minutes of services provided by a CNA or HHA who is also certified as a CMT to each of two or more participants in the same residence;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>$5.6520 for 15 minutes of services provided by a CNA or HHA to one participant;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>$3.8983 for 15 minutes of services provided by a CNA or HHA to two or more participants in the same residence; and</text>
      </paragraph>
      <paragraph num="(i)">
        <text>A flat rate of $79.44 per visit for a registered nurse supervisory visit of a nurse, CNA, or HHA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>The Program’s rates as specified in this regulation shall adjust each year, subject to the limitations of the State budget.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The nursing services provider shall identify the individual who ordered the nursing services by recording the individual practitioner’s National Provider Identifier (NPI) number on the claim.</text>
  </paragraph>
</regulation>